Plasma cotinine levels and pancreatic cancer in the EPIC cohort study.

TitlePlasma cotinine levels and pancreatic cancer in the EPIC cohort study.
Publication TypeJournal Article
Year of Publication2012
AuthorsLeenders M, Chuang S-C, Dahm CC, Overvad K, Ueland P M, Midttun O, Vollset S E, Tjønneland A, Halkjaer J, Jenab M, Clavel-Chapelon F, Boutron-Ruault M-C, Kaaks R, Canzian F, Boeing H, Weikert C, Trichopoulou A, Bamia C, Naska A, Palli D, Pala V, Mattiello A, Tumino R, Sacerdote C, van Duijnhoven FJB, Peeters PHM, van Gils CH, Lund E, Rodriguez L, Duell EJ, Pérez M-J S, Molina-Montes E, Castaño J M H, Barricarte A, Larrañaga N, Johansen D, Lindkvist B, Sund M, Ye W, Khaw K-T, Wareham NJ, Michaud DS, Riboli E, Xun WW, Allen NE, Crowe FL, Bueno-de-Mesquita BH, Vineis P
JournalInt J Cancer
Volume131
Issue4
Pagination997-1002
Date Published2012 Aug 15
ISSN1097-0215
KeywordsCase-Control Studies, Chromatography, Liquid, Cohort Studies, Cotinine, Female, Humans, Logistic Models, Male, Mass Spectrometry, Pancreatic Neoplasms, Smoking
Abstract

Smoking is an established risk factor for pancreatic cancer, previously investigated by the means of questionnaires. Using cotinine as a biomarker for tobacco exposure allows more accurate quantitative analyses to be performed. This study on pancreatic cancer, nested within the European Prospective Investigation into Cancer and Nutrition (EPIC cohort), included 146 cases and 146 matched controls. Using liquid chromatography-mass spectrometry, plasma cotinine levels were analyzed on average 8.0 years before cancer onset (5-95% range: 2.8-12.0 years). The relation between plasma cotinine levels and pancreatic cancer was analyzed with conditional logistic regression for different levels of cotinine in a population of never and current smokers. This was also done for the self-reported number of smoked cigarettes per day at baseline. Every increase of 350 nmol/L of plasma cotinine was found to significantly elevate risk of pancreatic cancer [odds ratio (OR): 1.33, 95% confidence interval (CI): 1.11-1.60]. People with a cotinine level over 1187.8 nmol/L, a level comparable to smoking 17 cigarettes per day, have an elevated risk of pancreatic cancer, compared to people with cotinine levels below 55 nmol/L (OR: 3.66, 95% CI: 1.44-9.26). The results for self-reported smoking at baseline also show an increased risk of pancreatic cancer from cigarette smoking based on questionnaire information. People who smoke more than 30 cigarettes per day showed the highest risk compared to never smokers (OR: 4.15, 95% CI: 1.02-16.42). This study is the first to show that plasma cotinine levels are strongly related to pancreatic cancer.

DOI10.1002/ijc.26452
Alternate JournalInt. J. Cancer
PubMed ID21953524