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Smoking, heavy drinking linked to earlier onset of pancreatic cancer

University of Michigan Health System study makes step toward learning when cancer screenings should start

Those who smoke and drink heavily may develop pancreatic cancer at an earlier age than those who don't, according to a study led by a University of Michigan Health System gastroenterologist.

In the study, published in the American Journal of Gastroenterology, heavy smokers with pancreatic cancer were diagnosed around age 62 and heavy drinkers at age 61 – almost a decade earlier than the average age of 72.

Smoking is a strong risk factor for pancreatic cancer and alcohol has been shown to cause oxidative damage to the pancreas, which sets the stage for the inflammatory pathways that can lead to cancer.

The findings only indicate these habits can lead to developing pancreatic cancer earlier in life.

The study of 811 pancreatic cancer patients from the multicenter, international database Pancreatic Cancer Collaborative Registry does not prove the habits caused cancer.

The study does make a step toward understanding at what age screening for pancreatic cancer should begin – once widespread screening is available.

"As screening programs are developed, an understanding of how personal features influence the age of presentation will be important to optimize the timing of those screenings," says lead study author and gastroenterologist Michelle Anderson, M.D., assistant professor of internal medicine at the University of Michigan Health System. Detecting pancreatic cancer early is difficult and contributes to the poor survival rates. By the time pancreatic cancer is diagnosed, it is frequently at an advanced stage and has spread to other organs.

Currently there are no tests available to easily find it in people who do not have symptoms. In the study, heavy smokers were defined as those who had more than a pack per day, and heavy drinking was measured at more than 39 grams a day, or about three average drinks per day.

Beer drinkers presented with pancreatic cancer earlier than those who drank other types of alcohol, such as wine or hard liquor although when adjusted for the amount of alcohol consumed, the type of alcohol did not affect the age of presentation.

The good news is that the harmful effects of heavy drinking and smoking can be resolved . After 10 years, former smokers and drinkers who quit their habits faced no extra risk of earlier diagnosis.

The registry used for the study gathers information on patients with pancreatic cancer and those at high-risk for developing pancreatic cancer.

Patient data was collected from University of Nebraska Medical Center, Omaha, Neb.; University of Genoa, Italy; Creighton University School of Medicine, Omaha, Neb.; University of Pittsburgh Medical Center; NorthShore University Health System, Evanston, Ill.; University of Chicago, Chicago, Ill.; University of Alabama at Birmingham, Ala.; and the University of Michigan Health System, Ann Arbor, Mich.

Funding: This work was supported by the following grants: NIH K23 DK082097, NCI T32 CA 083654, NIH R01 CA140940, and Italian Ministry of Health DGRST.4/4235-P1.9.A.B.

Reference: "Alcohol and Tobacco Lower the Age of Presentation in Sporadic Pancreatic Cancer in a Dose-Dependent Manner: A Multicenter Study," American Journal of Gastroenterology.

On the Web

Pancreatic Cancer Collaborative Registry (PCCR)

University of Michigan Division of Gastroenterology

University of Michigan Comprehensive Cancer Center

Shantell M. Kirkendoll | EurekAlert!
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