Cigarette smoking and other lifestyle factors in relation to the risk of pancreatic cancer death: A prospective cohort study in Japan
Objective: To examine the association of smoking and lifestyle factors with pancreatic cancer death in the prospective design. Methods: Mortality from pancreatic cancer in regard to smoking, body mass index, physical activity, and alcohol, coffee and green tea intake, was studied in a prospective cohort of 30 826 inhabitants in Takayama, Japan. In 1992, each subject completed a self-administered questionnaire on demographic information, smoking, drinking habits, diet, exercise and medical histories. The response rate was 85.3%. Results: From 1992 to 1999, 33 men and 19 women died due to pancreatic cancer. Hazard ratios and 95% confidence intervals were determined using Cox proportional hazards models. Women who were defined as current smokers at baseline had significant and increased risk of pancreatic cancer death after adjustment for age, body mass index and history of diabetes mellitus (Hazard ratio:4.77, 95% confidence intervals:1.58-14.4). There were significant positive associations of pancreatic cancer death with the years of smoking and the number of cigarettes consumed daily in women in a dose-dependent manner. Current smokers indicated a non-significant risk increase in men (Hazard ratio: 3.81, 95% confidence intervals: 0.88-16.6). Body mass index, physical activity, and alcohol, coffee and green tea intake were not significantly associated with pancreatic cancer death. Conclusions: These data suggested that smoking increases the risk of death from pancreatic cancer in Japanese women.