Epidemiology and Prospects for Prevention of Pancreatic Cancer

  • Li Jiao
  • Donghui Li


The overall incidence of pancreatic cancer in the United States is approximately 8–10 cases per 100,000 person-years. African Americans have higher incidence rate than other ethnic groups. Men have a slightly higher incidence than women. Age is the most significant risk factor for pancreatic cancer. Genetic predispositions account for 5–10% of cases. Cigarette smoking is the only confirmed environmental risk factor and long-term smoking cessation reduces the risk. The causal relationship between high body mass index and risk has been established. Diabetes could be the manifestation of pancreatic cancer, but long-standing type II diabetes mellitus has been implicated as a risk factor. Other suspected risk factors for pancreatic cancer include alcohol and pancreatitis. Heavy alcohol use, especially heavy liquor use, may serve as a cofactor in pancreatic cancer development. However, the confounding effect by smoking cannot be excluded. Chronic pancreatitis may increase the risk for pancreatic cancer but the confounding effect of alcohol cannot be excluded. Dietary factors that have been suggested to associate with increased risk of pancreatic cancer include: high intake of total energy, total fat, red meat, animal protein and dietary mutagens. Dietary intake of folate and flavonoid may be protective against pancreatic cancer but the results are inconclusive. The association of pancreatic cancer with passive smoking, non-cigarette tobacco product use, carbohydrate intake, coffee consumption, physical activity, infectious factors, allergy, occupation and use of NSAIDs or statins are all inconclusive. Other than tobacco carcinogen, epidemiologic studies support that insulin resistance, energy imbalance and inflammation may be the underlying mechanisms in pancreatic cancer development. In view of the high mortality of pancreatic cancer, an appropriate strategy for reducing the burden of this cancer is to reduce exposure to known risk factors such as cigarette smoking, obesity and diabetes. Lifestyle changes hold the hope for primary prevention of pancreatic cancer. Well-designed epidemiologic studies will speed up our understanding on the etiology of pancreatic cancer.


Pancreatic Cancer Chronic Pancreatitis Familial Adenomatous Polyposis Glycemic Index Glycemic Load 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Parkin DM, Bray F, Ferlay J, Pisani P: Global cancer statistics, 2002. CA Cancer J Clin 2005;55:74–108.PubMedGoogle Scholar
  2. 2.
    World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC: AICR, 2007, pp. 271–274.Google Scholar
  3. 3.
    Parkin DM, Muir CS: Cancer incidence in five continents. Comparability and quality of data. IARC Sci Publ 1992;120:45–173.PubMedGoogle Scholar
  4. 4.
    Ries L, Melbert D, Krapcho M, et al.: SEER Cancer Statistics Review, 1975–2005. Bethesda: National Cancer Institute, 2008.Google Scholar
  5. 5.
    Anderson K, Potter JD, Mack TM: Pancreatic cancer. In Cancer Epidemiology and Prevention. Schottenfeld, D Fraumeni, JF Jr., (eds.). New York: Oxford University Press, 2006, pp. 721–762.Google Scholar
  6. 6.
    Parkin DM: International variation. Oncogene 2004;23:6329–6340.PubMedGoogle Scholar
  7. 7.
    Silverman DT, Hoover RN, Brown LM, Swanson GM, Schiffman M, Greenberg RS, Hayes RB, Lillemoe KD, Schoenberg JB, Schwartz AG, Liff J, Pottern LM, Fraumeni JF, Jr: Why do Black Americans have a higher risk of pancreatic cancer than White Americans? Epidemiology 2003;14:45–54.PubMedGoogle Scholar
  8. 8.
    Greer JB, Whitcomb DC, Brand RE: Genetic predisposition to pancreatic cancer: a brief review. Am J Gastroenterol 2007;102:2564–2569.PubMedGoogle Scholar
  9. 9.
    Lynch HT, Lanspa SJ, Fitzgibbons RJ, Jr., Smyrk T, Fitzsimmons ML, McClellan J: Familial pancreatic cancer (Part 1): Genetic pathology review. Nebr Med J 1989;74:109–112.PubMedGoogle Scholar
  10. 10.
    Murphy KM, Brune KA, Griffin C, Sollenberger JE, Petersen GM, Bansal R, Hruban RH: Kern SE.Evaluation of candidate genes MAP2K4, MADH4, ACVR1B, and BRCA2 in familial pancreatic cancer: deleterious BRCA2 mutations in 17%. Cancer Res 2002;62:3789–3793.PubMedGoogle Scholar
  11. 11.
    Goggins M, Schutte M, Lu J, Moskaluk CA, Weinstein CL, Petersen GM, Yeo CJ, Jackson CE, Lynch HT, Hruban RH, Kern SE: Germline BRCA2 gene mutations in patients with apparently sporadic pancreatic carcinomas. Cancer Res 1996;56:5360–5364.PubMedGoogle Scholar
  12. 12.
    Klein AP, Hruban RH, Brune KA, Petersen GM, Goggins M: Familial pancreatic cancer. Cancer J 2001;7:266–273.PubMedGoogle Scholar
  13. 13.
    Goldstein AM, Fraser MC, Struewing JP, Hussussian CJ, Ranade K, Zametkin DP, Fontaine LS, Organic SM, Dracopoli NC, Clark WH, Jr., et al.: Increased risk of pancreatic cancer in melanoma-prone kindreds with p16INK4 mutations. N Engl J Med 1995;333:970–974.PubMedGoogle Scholar
  14. 14.
    Lynch HT, Brand RE, Hogg D, Deters CA, Fusaro RM, Lynch JF, Liu L, Knezetic J, Lassam NJ, Goggins M, Kern S: Phenotypic variation in eight extended CDKN2A germline mutation familial atypical multiple mole melanoma-pancreatic carcinoma-prone families: the familial atypical mole melanoma-pancreatic carcinoma syndrome. Cancer 2002;94:84–96.PubMedGoogle Scholar
  15. 15.
    Hemminki A, Markie D, Tomlinson I, Avizienyte E, Roth S, Loukola A, Bignell G, Warren W, Aminoff M, Hoglund P, Jarvinen H, Kristo P, Pelin K, Ridanpaa M, Salovaara R, Toro T, Bodmer W, Olschwang S, Olsen AS, Stratton MR, de la Chapelle A, Aaltonen LA: A serine/threonine kinase gene defective in Peutz-Jeghers syndrome. Nature 1998;391(6663):184–187.PubMedGoogle Scholar
  16. 16.
    Giardiello FM, Brensinger JD, Tersmette AC, Goodman SN, Petersen GM, Booker SV, Cruz-Correa M, Offerhaus JA: Very high risk of cancer in familial Peutz-Jeghers syndrome. Gastroenterology 2000;119(6):1447–1453.PubMedGoogle Scholar
  17. 17.
    Su GH, Hruban RH, Bansal RK, Bova GS, Tang DJ, Shekher MC, Westerman AM, Entius MM, Goggins M, Yeo CJ, Kern SE: Germline and somatic mutations of the STK11/LKB1 Peutz-Jeghers gene in pancreatic and biliary cancers. Am J Pathol 1999;154(6):1835–1840.PubMedGoogle Scholar
  18. 18.
    Lim W, Olschwang S, Keller JJ, Westerman AM, Menko FH, Boardman LA, Scott RJ, Trimbath J, Giardiello FM, Gruber SB, Gille JJ, Offerhaus GJ, de Rooij FW, Wilson JH, Spigelman AD, Phillips RK, Houlston RS: Relative frequency and morphology of cancers in STK11 mutation carriers. Gastroenterology 2004;126:1788–1794.PubMedGoogle Scholar
  19. 19.
    Varley JM: Germline TP53 mutations and Li-Fraumeni syndrome. Hum Mutat 2003;21(3):313–320.PubMedGoogle Scholar
  20. 20.
    Cowgill SM, Muscarella P: The genetics of pancreatic cancer. Am J Surg 2003;186(3):279–286.PubMedGoogle Scholar
  21. 21.
    Giardiello FM, Offerhaus GJ, Lee DH, Krush AJ, Tersmette AC, Booker SV, Kelley NC, Hamilton SR: Increased risk of thyroid and pancreatic carcinoma in familial adenomatous polyposis. Gut 1993;34(10):1394–1396.PubMedGoogle Scholar
  22. 22.
    Whitcomb DC, Gorry MC, Preston RA, Furey W, Sossenheimer MJ, Ulrich CD, Martin SP, Gates LK, Jr., Amann ST, Toskes PP, Liddle R, McGrath K, Uomo G, Post JC: Ehrlich GD, Hereditary pancreatitis is caused by a mutation in the cationic trypsinogen gene. Nat Genet 1996;14(2):141–145.PubMedGoogle Scholar
  23. 23.
    Lowenfels AB, Maisonneuve P, DiMagno EP, Elitsur Y, Gates LK, Jr., Perrault J, Whitcomb DC: Hereditary pancreatitis and the risk of pancreatic cancer. International Hereditary Pancreatitis Study Group. J Natl Cancer Inst 1997;89(6):442–446.PubMedGoogle Scholar
  24. 24.
    Keim V: Role of genetic disorders in acute recurrent pancreatitis. World J Gastroenterol 2008;14(7):1011–1015.PubMedGoogle Scholar
  25. 25.
    Lowenfels AB, Maisonneuve P, Whitcomb DC: Risk factors for cancer in hereditary pancreatitis. International Hereditary Pancreatitis Study Group. Med Clin North Am 2000;84(3):565–573.PubMedGoogle Scholar
  26. 26.
    Tersmette AC, Petersen GM, Offerhaus GJ, Falatko FC, Brune KA, Goggins M, Rozenblum E, Wilentz RE, Yeo CJ, Cameron JL, Kern SE, Hruban RH: Increased risk of incident pancreatic cancer among first-degree relatives of patients with familial pancreatic cancer. Clin Cancer Res 2001;7:738–744.PubMedGoogle Scholar
  27. 27.
    Permuth-Wey J: Egan KM. Family history is a significant risk factor for pancreatic cancer: results from a systematic review and meta-analysis. Fam Can 2009;8:109–117.Google Scholar
  28. 28.
    Eberle MA, Pfutzer R, Pogue-Geile KL, Bronner MP, Crispin D, Kimmey MB, Duerr RH, Kruglyak L, Whitcomb DC, Brentnall TA: A new susceptibility locus for autosomal dominant pancreatic cancer maps to chromosome 4q32–34. Am J Hum Genet 2002;70:1044–1048.PubMedGoogle Scholar
  29. 29.
    Pogue-Geile KL, Chen R, Bronner MP, Crnogorac-Jurcevic T, Moyes KW, Dowen S, Otey CA, Crispin DA, George RD, Whitcomb DC, Brentnall TA: 2006;Palladin mutation causes familial pancreatic cancer and suggests a new cancer mechanism. PLoS Med e516.3:Google Scholar
  30. 30.
    Slater E, Amrillaeva V, Fendrich V, Bartsch D, Earl J, Vitone LJ, Neoptolemos JP, Greenhalf W: 2007;Palladin mutation causes familial pancreatic cancer: absence in European families. PLoS Med e164.4:PubMedGoogle Scholar
  31. 31.
    Klein AP, de Andrade M, Hruban RH, Bondy M, Schwartz AG, Gallinger S, Lynch HT, Syngal S, Rabe KG, Goggins MG, Petersen GM: Linkage analysis of chromosome 4 in families with familial pancreatic cancer. Cancer Biol Ther 2007;6:320–323.PubMedGoogle Scholar
  32. 32.
    Iodice S, Gandini S, Maisonneuve P, Lowenfels AB: Tobacco and the risk of pancreatic cancer: a review and meta-analysis. Langenbecks Arch Surg 2008;393:535–545.PubMedGoogle Scholar
  33. 33.
    Thompson PA, Seyedi F, Lang NP, McLeod SL, Woogen GN, Anderson KE, Tang YM, Coles B, Kadlubar FF: Comparison of DNA adduct levels associated with exogenous and endogenous exposures in human pancreas in relation to metabolic genotype. Mutat Res 1999;424:263–274.PubMedGoogle Scholar
  34. 34.
    Wang M-Y, Abbruzzese JL, Friess H, Hittelman WN, Evans DB, Abbruzzese MC, Chiao PL, Li D: DNA adducts in human pancreatic tissues and their potential role in carcinogenesis. Cancer Res 1998;58:38–41.PubMedGoogle Scholar
  35. 35.
    Prokopczyk B, Hoffmann D, Bologna M, Cunningham AJ, Trushin N, Akerkar S, Boyiri T, Amin S, Desai D, Colosimo S, Pittman B, Ledger G, Ramadani M, Henne-Bruns D, Beger HG, El-Bayoumy K: Identification of tobacco-derived compounds in human pancreatic juice. Chem Res Toxicol 2002;15:677–685.PubMedGoogle Scholar
  36. 36.
    Duell EJ, Wiencke JK, Cheng T-J, Varkonyi A, Zuo ZF, Ashok TD, Mark EJ, Wain JC, Christiani DC, Kelsey KT: Polymorphisms in the DNA repair genes XRCC1 and ERCC2 and biomarkers of DNA damage in human blood mononuclear cells. Carcinogenesis 2000;21:965–971 [published erratum appears in Carcinogenesis (Lond.) 2000;21:1457].PubMedGoogle Scholar
  37. 37.
    Duell EJ, Holly EA, Bracci PM, Liu M, Wiencke JK, Kelsey KT: A population-based, case-control study of polymorphisms in carcinogen-metabolizing genes, smoking, and pancreatic adenocarcinoma risk. J Natl Cancer Inst 2002;4:297–306.Google Scholar
  38. 38.
    Suzuki H, Jiao L, Li Y, Doll MA, Hein DW, Hassan MM, Day RS, Bondy ML, Abbruzzese JL, Li D: Interaction of the Cytochrome P4501A2, SULT1A1 and NAT gene polymorphisms with smoking and dietary mutagen intake in modification of the risk of pancreatic cancer. Carcinogenesis 2008;29(6):1184–1191.PubMedGoogle Scholar
  39. 39.
    McWilliams RC, Bamlet WR, Cunningham JM, Goode EL, de Andrade M, Boardman LA, Petersen GM: 2008;Polymorphisms in DNA Repair Genes, Smoking, and Pancreatic Adenocarcinoma Risk Cancer Res 68(12):4928–4935.Google Scholar
  40. 40.
    Li D, Suzuki H, Liu B, Morris J, Liu J, Okazaki T, Li Y, Chang P, Abbruzzese JL. DNA repair gene polymorphisms and risk of pancreatic cancer. Clin Can Res 2009;15(2):740–746.Google Scholar
  41. 41.
    Hruban RH, van Mansfeld AD, Offerhaus GJ, van Weering DH, Allison DC, Goodman SN, Kensler TW, Bose KK, Cameron JL, Bos JL: K-ras oncogene activation in adenocarcinoma of the human pancreas. A study of 82 carcinomas using a combination of mutant-enriched polymerase chain reaction analysis and allele-specific oligonucleotide hybridization. Am J Pathol 1993;143:545–554.PubMedGoogle Scholar
  42. 42.
    Jiao L, Zhu JJ, Hassan M, Abbruzzese JL, Li D: K-ras mutation and p16 and preproenkephalin promoter hypermethylation in plasma DNA of pancreatic cancer patients in relation to cigarette smoking. Pancreas 2007;34:55–62.PubMedGoogle Scholar
  43. 43.
    Baker F, Ainsworth SR, Dye JT, Crammer C, Thun MJ, Hoffmann D, Repace JL, Henningfield JE, Slade J, Pinney J, Shanks T, Burns DM, Connolly GN, Shopland DR: Health risks associated with cigar smoking. JAMA 2000;284:735–740.PubMedGoogle Scholar
  44. 44.
    Henley SJ, Thun MJ, Chao A, Calle EE: Association between exclusive pipe smoking and mortality from cancer and other diseases. J Natl Cancer Inst 2004;96:853–861.PubMedGoogle Scholar
  45. 45.
    Boffetta P, Aagnes B, Weiderpass E, Andersen A: Smokeless tobacco use and risk of cancer of the pancreas and other organs. Int J Cancer 2005;114:992–995.PubMedGoogle Scholar
  46. 46.
    Shapiro JA, Jacobs EJ, Thun MJ: Cigar smoking in men and risk of death from tobacco-related cancers. J Natl Cancer Inst 2000;92:333–337.PubMedGoogle Scholar
  47. 47.
    Alguacil J, Silverman DT: Smokeless and other noncigarette tobacco use and pancreatic cancer: a case-control study based on direct interviews. Cancer Epidemiol Biomarkers Prev 2004;13:55–58.PubMedGoogle Scholar
  48. 48.
    Hassan MM, Abbruzzese JL, Bondy ML, Wolff RA, Vauthey J-N, Pisters PW, Evans DB, Khan R, Chou T-H, Lenzi R, Jiao L, Li D: Passive smoking and use of noncigarette tobacco products and risk for pancreatic cancer: case-control study. Cancer 2007;109:2547–2556.PubMedGoogle Scholar
  49. 49.
    Villeneuve PJ, Johnson KC, Mao Y, Hanley AJ: Environmental tobacco smoke and the risk of pancreatic cancer: findings from a Canadian population-based case-control study. Can J Public Health 2004;95:32–37.PubMedGoogle Scholar
  50. 50.
    Gallicchio L, Kouzis A, Genkinger JM, Burke AE, Hoffman SC, Diener-West M, Helzlsouer KJ, Comstock GW, Alberg AJ: Active cigarette smoking, household passive smoke exposure, and the risk of developing pancreatic cancer. Prev Med 2006;42(3):200–205.PubMedGoogle Scholar
  51. 51.
    Berrington de Gonzalez A, Sweetland S, Spencer E: A meta-analysis of obesity and the risk of pancreatic cancer. Br J Cancer 2003;89:519–523.PubMedGoogle Scholar
  52. 52.
    Larsson SC, Orsini N, Wolk A: Body mass index and pancreatic cancer risk: A meta-analysis of prospective studies. Int J Cancer 2007;120:1993–1998.PubMedGoogle Scholar
  53. 53.
    Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M: Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 2008;371:569–578.PubMedGoogle Scholar
  54. 54.
    Calle EE, Kaaks R: Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004;8:579–591.Google Scholar
  55. 55.
    Larsson SC, Permert J, Hakansson N, Naslund I, Bergkvist L, Wolk A: Overall obesity, abdominal adiposity, diabetes and cigarette smoking in relation to the risk of pancreatic cancer in two Swedish population-based cohorts. Br J Cancer 2005;93:1310–1315.PubMedGoogle Scholar
  56. 56.
    Patel AV, Rodriguez C, Bernstein L, Chao A, Thun MJ, Calle EE: Obesity, recreational physical activity, and risk of pancreatic cancer in a large U.S. Cohort. Cancer Epidemiol Biomarkers Prev 2005;14:459–466.PubMedGoogle Scholar
  57. 57.
    Berrington de Gonzalez A, Spencer EA, Bueno-de-Mesquita HB, Roddam A, Stolzenberg-Solomon R, Halkjaer J, Tjonneland A, Overvad K, Clavel-Chapelon F, Boutron-Ruault MC, Boeing H, Pischon T, Linseisen J, Rohrmann S, Trichopoulou A, Benetou V, Papadimitriou A, Pala V, Palli D, Panico S, Tumino R, Vineis P, Boshuizen HC, Ocke MC, Peeters PH, Lund E, Gonzalez CA, Larranaga N, Martinez-Garcia C, Mendez M, Navarro C, Quiros JR, Tormo MJ, Hallmans G, Ye W, Bingham SA, Khaw KT, Allen N, Key TJ, Jenab M, Norat T, Ferrari P, Riboli E: Anthropometry, physical activity, and the risk of pancreatic cancer in the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomarkers Prev 2006;15:879–885.PubMedGoogle Scholar
  58. 58.
    Stolzenberg-Solomon RZ, Adams K, Leitzmann M, Schairer C, Michaud DS, Hollenbeck A, Schatzkin A, Silverman DT: Adiposity, physical activity, and pancreatic cancer in the National Institutes of Health-AARP Diet and Health Cohort. Am J Epidemiol 2008;167:586–597.PubMedGoogle Scholar
  59. 59.
    Luo J, Margolis KL, Adami HO, LaCroix A, Ye W: Obesity and risk of pancreatic cancer among postmenopausal women: the Women’s Health Initiative (United States). Br J Cancer 2008;99:527–531.PubMedGoogle Scholar
  60. 60.
    Ansary-Moghaddam A, Huxley R, Barzi F, Lawes C, Ohkubo T, Fang X, Jee SH, Woodward M: The effect of modifiable risk factors on pancreatic cancer mortality in populations of the Asia-Pacific region. Cancer Epidemiol Biomarkers Prev 2006;15:2435–2440.PubMedGoogle Scholar
  61. 61.
    IARC. IARC handbooks on cancer prevention: Weight control and physical activity. Lyon, France: IARC Press, 2002.Google Scholar
  62. 62.
    Michaud DS, Giovannucci E, Willet WC, Colditz GA, Stampfer MJ, Fuchs CS: Physical activity, obesity, height, and the risk of pancreatic cancer. JAMA 2001;286(8):921–929.PubMedGoogle Scholar
  63. 63.
    Fisher WE: Diabetes: risk factor for the development of pancreatic cancer or manifestation of the disease? World J Surg 2001;25:503–508.PubMedGoogle Scholar
  64. 64.
    Gullo L, Pezzilli R, Morselli-Labate AM: Diabetes and the risk of pancreatic cancer. N Engl J Med 1994;331:81–84.PubMedGoogle Scholar
  65. 65.
    Valerio A, Basso D, Brigato L, Ceolotto G, Baldo G, Tiengo A, Plebani M: Glucose metabolic alterations in isolated and perfused rat hepatocytes induced by pancreatic cancer conditioned medium: a low molecular weight factor possibly involved. Biochem Biophys Res Commun 1999;257:622–628.PubMedGoogle Scholar
  66. 66.
    Basso D, Valerio A, Seraglia R, Mazza S, Piva MG, Greco E, Fogar P, Gallo N, Pedrazzoli S, Tiengo A, Plebani M: Putative pancreatic cancer-associated diabetogenic factor: 2030 MW peptide. Pancreas 2002;24:8–14.PubMedGoogle Scholar
  67. 67.
    Chow WH, Gridley G, Nyren O, Linet MS, Ekbom A, Fraumeni JF, Jr., Adami HO: Risk of pancreatic cancer following diabetes mellitus: a nationwide cohort study in Sweden. J Natl Cancer Inst 1995;87:930–931.PubMedGoogle Scholar
  68. 68.
    Everhart J, Wright D: Diabetes mellitus as a risk factor for pancreatic cancer. A meta-analysis. JAMA 1995;273:1605–1609.PubMedGoogle Scholar
  69. 69.
    Huxley RA, Ansary-Moghaddam A, de Gonzalez B, Barzi F, Woodward M: Type-II diabetes and pancreatic cancer: a meta-analysis of 36 studies. Br J Cancer. 2005;92:2076–2083.PubMedGoogle Scholar
  70. 70.
    Chari ST, Leibson CL, Rabe KG, Ransom J, de Andrade M, Petersen GM: Probability of pancreatic cancer following diabetes: a population-based study. Gastroenterology 2005;129:504–511.PubMedGoogle Scholar
  71. 71.
    Chari ST, Leibson CL, Rabe KG, Timmons LJ, Ransom J, de Andrade M, Petersen GM: Pancreatic cancer-associated diabetes mellitus: prevalence and temporal association with diagnosis of cancer. Gastroenterology 2008;134(1):95–101.PubMedGoogle Scholar
  72. 72.
    Pannala R, Leirness JB, Bamlet WR, Basu A, Petersen GM, Chari ST: Prevalence and clinical profile of pancreatic cancer-associated diabetes mellitus. Gastroenterology 2008;134(4):981–987.PubMedGoogle Scholar
  73. 73.
    Stevens RJ, Roddam AW, Beral V: Pancreatic cancer in type 1 and young-onset diabetes: systematic review and meta-analysis. Br J Cancer 2007;96:507–509.PubMedGoogle Scholar
  74. 74.
    Gapstur SM, Gann PH, Lowe W, Liu K, Colangelo L, Dyer A: Abnormal glucose metabolism and pancreatic cancer mortality. JAMA 2000;283:2552–2558.PubMedGoogle Scholar
  75. 75.
    Batty GD, Shipley MJ, Marmot M, Smith GD: Diabetes status and post-load plasma glucose concentration in relation to site-specific cancer mortality: findings from the original Whitehall study. Cancer Cause Control 2004;15:873–881.Google Scholar
  76. 76.
    Stattin P, Bjor O, Ferrari P, Lukanova A, Lenner P, Lindahl B, Hallmans G, Kaaks R: Prospective study of hyperglycemia and cancer risk. Diabetes Care 2007;30:561–567.PubMedGoogle Scholar
  77. 77.
    Stolzenberg-Solomon RZ, Graubard BI, Chari S, Limburg P, Taylor PR, Virtamo J, Albanes D: Insulin, glucose, insulin resistance, and pancreatic cancer in male smokers. JAMA 2005;294(22):2872–2878.PubMedGoogle Scholar
  78. 78.
    Pisani P: Hyper-insulinaemia and cancer, meta-analyses of epidemiological studies. Arch Physiol Biochem 2008;114(1):63–70.PubMedGoogle Scholar
  79. 79.
    Michaud DS, Wolpin B, Giovannucci E, Liu S, Cochrane B, Manson JE, Pollak MN, Ma J, Fuchs CS: Prediagnostic plasma C-peptide and pancreatic cancer risk in men and women. Cancer Epidemiol Biomarkers Prev 2007;16(10):2101–2109.PubMedGoogle Scholar
  80. 80.
    Wolpin BM, Michaud DS, Giovannucci EL, Schernhammer ES, Stampfer MJ, Manson JE, Chochrane BB, Rohan TE, Ma J, Pollak MN, Fuchs CS: Circulating insulin-like growth factor axis and the risk of pancreatic cancer in four prospective cohorts. Br J Cancer 2007;97(1):98–104.PubMedGoogle Scholar
  81. 81.
    Stolzenberg-Solomon RZ, Limburg P, Pollak M, Taylor PR, Virtamo J, Albanes D: Insulin-like growth factor (IGF)-1, IGF-binding protein-3, and pancreatic cancer in male smokers. Cancer Epidemiol Biomarkers Prev 2004;13:438–444.PubMedGoogle Scholar
  82. 82.
    Lin Y, Tamakoshi A, Kikuchi S, Yagyu K, Obata Y, Ishibashi T, Kawamura T, Inaba Y, Kurosawa M, Motohashi Y, Ohno Y: Serum insulin-like growth factor-I, insulin-like growth factor binding protein-3, and the risk of pancreatic cancer death. Int J Cancer 2004;110:584–588.PubMedGoogle Scholar
  83. 83.
    Wolpin BM, Michaud DS, Giovannucci EL, Schernhammer ES, Stampfer MJ, Manson JE, Cochrane BB, Rohan TE, Ma J, Pollak MN, Fuchs CS: Circulating insulin-like growth factor axis and the risk of pancreatic cancer in four prospective cohorts. Br J Cancer 2007;97:98–104.PubMedGoogle Scholar
  84. 84.
    Silverman DT, Brown LM, Hoover RN, Schiffman M, Lillemoe KD, Schoenberg JB, Swanson GM, Hayes RB, Greenberg RS, Benichou J, et al.: Alcohol and pancreatic cancer in blacks and whites in the United States. Cancer Res 1995;55:4899–4905.PubMedGoogle Scholar
  85. 85.
    Hassan MM, Wolff RA, Bondy ML, Abbruzzese JL, Vauthey J-N, Pisters PW, Evans DB, Khan R, Chou T-H, Lenzi R, Jiao L, Li D: Risk factors for pancreatic cancer: case-control study. Am J Gastroenterol 2007;102:2696–2707.PubMedGoogle Scholar
  86. 86.
    Lu XH, Wang L, Li H, Qian JM, Deng RX, Zhou L: Establishment of risk model for pancreatic cancer in Chinese Han population. World J Gastroenterol 2006;12:2229–2234.PubMedGoogle Scholar
  87. 87.
    Olsen GW, Mandel JS, Gibson RW, Wattenberg LW, Schuman LM: A case-control study of pancreatic cancer and cigarettes, alcohol, coffee and diet. Am J Public Health 1989;79:1016–1019.PubMedGoogle Scholar
  88. 88.
    Genkinger JM, Spiegelman D, Anderson KE, Bergkvist L, Bernstein L, Brandt PA, English DR, Freudenheim JL, Fuchs CS, Giles GG, Giovannucci E, Hankinson SE, Horn-Ross PL, Leitzmann M, Mannisto S, Marshall JR, McCullough ML, Miller AB, Douglas J, Reding KR, Rohan TE, Schatzkin A, Stevens, VL, Stolzenberg-Solomon RZ, Verhage BAJ, Wolk A, Ziegler RG, Smith-Warner SA: Alcohol intake and pancreatic cancer risk: a pooled analysis of fourteen cohort studies. Cancer Epidemiol Biomarkers Prev 2009;18:765–776.PubMedGoogle Scholar
  89. 89.
    Rohrmann S, Linseisen J, Vrieling A, Boffetta P, Stolzenberg-Solomon RZ, Lowenfels AB, Jensen MK, Overvad K, Olsen A, Tjonneland A, Boutron-Ruault MC, Clavel-Chapelon F, Fagherazzi G, Misirli G, Lagiou P, Trichopoulou A, Kaaks R, Bergmann MM, Boeing H, Bingham S, Khaw KT, Allen N, Roddam A, Palli D, Pala V, Panico S, Tumino R, Vineis P, Peeters PH, Hjartaker A, Lund E: Cornejo ML, Agudo A, Arriola L, Sanchez MJ, Tormo MJ, Barricarte Gurrea A, Lindkvist B, Manjer J, Johansson I, Ye W, Slimani N, Duell EJ, Jenab M, Michaud DS, Mouw T, Riboli E, Bueno-de-Mesquita HB: Ethanol intake and the risk of pancreatic cancer in the European prospective investigation into cancer and nutrition (EPIC). Cancer Cause Control 2009;20:785–794.Google Scholar
  90. 90.
    Jiao L, Silverman DT, Schairer C, Thiebaut A, Hollenbeck A, Leitzmann M, Schatzkin A, Stolzenberg-Solomon R: Alcohol use and risk of pancreatic cancer - The NIH-AARP Diet and Health Study. Am J Epidemiol 2009;169:1043–1051.PubMedGoogle Scholar
  91. 91.
    Steer ML, Waxman I, Freedman S: Chronic pancreatitis. N Engl J Med 1995;332:1482–1490.PubMedGoogle Scholar
  92. 92.
    Lowenfels AB, Maisonneuve P, Gavallini G, Ammann RW, Lankisch PG, Andersen JR, Dimagno EP, Andren-Sandberg A, Domellof L for The International Pancreatitis Study Group: Pancreatitis and the risk of pancreatic cancer. N Engl J Med 1993;328:1433–1437.PubMedGoogle Scholar
  93. 93.
    Talamini G, Falconi M, Bassi C, Sartori N, Salvia R, Caldiron E, Frulloni L, Di Francesco V, Vaona B, Bovo P, Vantini I, Pederzoli P, Cavallini G: Incidence of cancer in the course of chronic pancreatitis. Am J Gastroenterol 1999;94:1253–1260.PubMedGoogle Scholar
  94. 94.
    Karlson BM, Ekbom A, Josefsson S, McLaughlin JK, Fraumeni JF, Jr., Nyren O: The risk of pancreatic cancer following pancreatitis: an association due to confounding? Gastroenterology 1997;113:587–592.PubMedGoogle Scholar
  95. 95.
    Nothlings U, Wilkens LR, Murphy SP, Hankin JH, Henderson BE, Kolonel LN: Meat and fat intake as risk factors for pancreatic cancer: the multiethnic cohort study. J Natl Cancer Inst 2005;97(19):1458–1465.PubMedGoogle Scholar
  96. 96.
    Anderson KE, Sinha R, Kulldorff M, Gross M, Lang NP, Barber C, Harnack L, DiMagno E, Bliss R, Kadlubar FF: Meat intake and cooking techniques: associations with pancreatic cancer. Mutat Res 2002;506–7:225–231.Google Scholar
  97. 97.
    Li D, Day S, Bondy ML, Sinha R, Nguyen NT, Evans DB, Abbruzzese JL, Hassan M: Dietary mutagen exposure and risk of pancreatic cancer. Cancer Epidemiol Biomarkers Prev 2007;16:655–661.PubMedGoogle Scholar
  98. 98.
    Stolzenberg-Solomon RZ, Cross AJ, Silverman DT, Schairer C, Thompson FE, Kipnis V, Subar AF, Hellenbeck A, Schatzkin A, Sinha R: Meat and meat-mutagen intake and pancreatic cancer risk in the NIH-AARP cohort. Cancer Epidemiol Biomarkers Prev 2007;16(12):2664–2675.PubMedGoogle Scholar
  99. 99.
    Gold EB, Goldin SB: Epidemiology of and risk factors for pancreatic cancer. Surg Oncol Clin N AM 1998;7:67–91.PubMedGoogle Scholar
  100. 100.
    Larsson SC, Hakansson N, Naslund I, Bergkvist L, Wolk A: Fruit and vegetable consumption in relation to pancreatic cancer risk: a prospective study. Cancer Epidemiol Biomarkers Prev 2006;15:301–305.PubMedGoogle Scholar
  101. 101.
    Vrieling A, Verhage BA, van Duijnhoven FJ, Jenab M, Overvad K, Tjonneland A, Olsen A, Clavel-Chapelon F, Boutron-Ruault MC, Kaaks R, Rohrmann S, Boeing H, Nothlings U, Trichopoulou A, John T, Dimosthenes Z, Palli D, Sieri S, Mattiello A, Tumino R, Vineis P, van Gils CH, Peeters PH, Engeset D, Lund E, Rodriguez Suarez L, Jakszyn P, Larranaga N, Sanchez MJ, Chirlaque MD, Ardanaz E: Manjer J, Lindkvist B, Hallmans G, Ye W, Bingham S, Khaw KT, Roddam A, Key T, Boffetta P, Duell EJ, Michaud DS, Riboli E, Bueno-de-Mesquita HB: Fruit and vegetable consumption and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition. Int J Cancer 2009;124:1926–1934.PubMedGoogle Scholar
  102. 102.
    Nothlings U, Wilkens LR, Murphy SP, Hankin JH, Henderson BE, Kolonel LN: Vegetable intake and pancreatic cancer risk: the multiethnic cohort study. Am J Epidemiol 2007;165:138–147.PubMedGoogle Scholar
  103. 103.
    Bae JM, Lee EJ, Guyatt G: Citrus fruit intake and pancreatic cancer risk: a quantitative systematic review. Pancreas 2009;38:168–174.PubMedGoogle Scholar
  104. 104.
    Chan JM, Wang F, Holly EA: Vegetable and fruit intake and pancreatic cancer in a population-based case-control study in the San Francisco bay area. Cancer Epidemiol Biomarkers Prev 2005;14:2093–2097.PubMedGoogle Scholar
  105. 105.
    Nothlings U, Murphy SP, Wilkens LR, Henderson BE, Kolonel LN: Flavonols and pancreatic cancer risk: the multiethnic cohort study. Am J Epidemiol 2007;166:924–931.PubMedGoogle Scholar
  106. 106.
    Bobe G, Weinstein SJ, Albanes D, Hirvonen T, Ashby J, Taylor PR, Virtamo J, Stolzenberg-Solomon RZ: Flavonoid intake and risk of pancreatic cancer in male smokers (Finland). Cancer Epidemiol Biomarkers Prev 2008;17:553–562.PubMedGoogle Scholar
  107. 107.
    Larsson SC, Giovannucci E, Wolk A: Folate intake, MTHFR polymorphisms, and risk of esophageal, gastric, and pancreatic cancer: a meta-analysis. Gastroenterology 2006;131:1271–1283.PubMedGoogle Scholar
  108. 108.
    Larsson SC, Hakansson N, Giovannucci E, Wolk A: Folate intake and pancreatic cancer incidence: a prospective study of Swedish women and men. J Natl Cancer Inst 2006;98:407–413.PubMedGoogle Scholar
  109. 109.
    Stolzenberg-Solomon RZ, Albanes D, Nieto FJ, Hartman TJ, Tangrea JA, Rautalahti M, Sehlub J, Virtamo J, Taylor PR: Pancreatic cancer risk and nutrition-related methyl-group availability indicators in male smokers. J Natl Cancer Inst 1999;91:535–541.PubMedGoogle Scholar
  110. 110.
    Schernhammer E, Wolpin B, Rifai N, Cochrane B, Manson JA, Ma J, Giovannucci E, Thomson C, Stampfer MJ, Fuchs C: Plasma folate, vitamin B6, vitamin B12, and homocysteine and pancreatic cancer risk in four large cohorts. Cancer Res 2007;67:5553–5560.PubMedGoogle Scholar
  111. 111.
    Skinner HG, Michaud DS, Giovannucci EL, Rimm EB, Stampfer MJ, Willett WC, Colditz GA, Fuchs CS: A prospective study of folate intake and the risk of pancreatic cancer in men and women. Am J Epidemiol 2004;160(3):248–258.PubMedGoogle Scholar
  112. 112.
    Silverman DT, Swanson CA, Gridley G, Wacholder S, Greenberg RS, Brown LM, Hayes RB, Swanson GM, Schoenberg JB, Pottern LM, Schwartz AG, Fraumeni JF, Jr., Hoover RN: Dietary and nutritional factors and pancreatic cancer: a case-control study based on direct interviews. J Natl Cancer Inst 1998;90:1710–1719.PubMedGoogle Scholar
  113. 113.
    Nkondjock A, Ghadirian P, Johnson KC, Krewski D: Dietary intake of lycopene is associated with reduced pancreatic cancer risk. J Nutr 2005;135:592–597.PubMedGoogle Scholar
  114. 114.
    Kavanaugh CJ, Trumbo PR, Ellwood KC: The US Food and Drug Administration’s evidence-based review for qualified health claims: tomatoes, lycopene, and cancer. J Natl Cancer Inst 2007;99:1074–1085.PubMedGoogle Scholar
  115. 115.
    Bjelakovic G, Nikolova D, Simonetti RG, Gluud C: Antioxidant supplements for prevention of gastrointestinal cancers: a systematic review and meta-analysis. Lancet 2004;364:1219–1228.PubMedGoogle Scholar
  116. 116.
    Howe GR, Ghadirian P, Bueno de Mesquita HB, Zatonski WA, Baghurst PA, Miller AB, Simard A, Baillargeon J, de Waard F, Przewozniak K, et al.: A collaborative case-control study of nutrient intake and pancreatic cancer within the search programme. Int J Cancer 1992;51(3):365–372.PubMedGoogle Scholar
  117. 117.
    Howe GR Burch JD: Nutrition and pancreatic cancer. Cancer Cause Control 1996;7(1):69–82.Google Scholar
  118. 118.
    Michaud DS, Liu S, Giovannucci E, Willett WC, Colditz GA, Fuchs CS: Dietary sugar, glycemic load, and pancreatic cancer risk in a prospective study. J Natl Cancer Inst 2002;94(17):1293–1300.PubMedGoogle Scholar
  119. 119.
    Johnson KJ, Anderson KE, Harnack L, Hong CP, Folsom AR: No association between dietary glycemic index or load and pancreatic cancer incidence in postmenopausal women. Cancer Epidemiol Biomarkers Prev 2005;14:1574–1575.PubMedGoogle Scholar
  120. 120.
    Silvera SA, Rohan TE, Jain M, Terry PD, Howe GR, Miller AB: Glycemic index, glycemic load, and pancreatic cancer risk (Canada). Cancer Cause Control 2005;16:431–436.Google Scholar
  121. 121.
    Patel AV, McCullough ML, Pavluck AL, Jacobs EJ, Thun MJ, Calle EE: Glycemic load, glycemic index, and carbohydrate intake in relation to pancreatic cancer risk in a large US cohort. Cancer Cause Control 2007;18:287–294.Google Scholar
  122. 122.
    Nothlings U, Murphy SP, Wilkens LR, Henderson BE, Kolonel LN: Dietary glycemic load, added sugars, and carbohydrates as risk factors for pancreatic cancer: the Multiethnic Cohort Study. Am J Clin Nutr 2007;86:1495–1501.PubMedGoogle Scholar
  123. 123.
    Heinen MM, Verhage BA, Lumey L, Brants HA, Goldbohm RA, van den Brandt PA: Glycemic load, glycemic index, and pancreatic cancer risk in the Netherlands Cohort Study. Am J Clin Nutr 2008;87:970–977.PubMedGoogle Scholar
  124. 124.
    Jiao L, Flood A, Subar AF, Hollenbeck A, Schatzkin A: Stolzenberg-Solomon R. Glycemic index, available carbohydrate, glycemic load and risk of pancreatic cancer in the NIH-AARP Diet and Health Study. Cancer Epidemiol Biomarkers Prev 2009; 18(4):1144–1151.Google Scholar
  125. 125.
    Mulholland HG, Murray LJ, Cardwell CR, Cantwell MM: Glycemic index, glycemic load, and risk of digestive tract neoplasms: a systematic review and meta-analysis. Am J Clin Nutr 2009;89:568–576.PubMedGoogle Scholar
  126. 126.
    Bao Y, Stolzenberg-Solomon R, Jiao L, Silverman DT, Subar AF, Park Y, Leitzmann MF, Hollenbeck A, Schatzkin A, Michaud DS: Added sugar and sugar-sweetened foods and beverages and the risk of pancreatic cancer in the National Institutes of Health-AARP Diet and Health Study. Am J Clin Nutr 2008;88:431–440.PubMedGoogle Scholar
  127. 127.
    Raderer M, Wrba F, Kornek G, et al.: Association between Helicobacter pylori infection and pancreatic cancer. Oncology 1998;55:16–19.PubMedGoogle Scholar
  128. 128.
    Stolzenberg-Solomon RZ, Blaser MJ, Limburg PJ, et al.: Helicobacter pylori seropositivity as a risk factor for pancreatic cancer. J Nat Cancer Inst 2001;93:927–941.Google Scholar
  129. 129.
    Hassan MM, Li D, El-Deeb A, Wolff RA, Bondy ML, Davila M, Abbruzzese JL: Hepatitis B Virus and pancreatic cancer. J Clin Oncol 2008;26(28):4557–4562.PubMedGoogle Scholar
  130. 130.
    Tersmette AC, Offerhaus GJ, Giardiello FM, et al.: Occurrence of non-gastric cancer in the digestive tract after remote partial gastrectomy: analysis of an Amsterdam cohort. Int J Cancer 1990;465:792–795.Google Scholar
  131. 131.
    Hedberg M, Ogren M, Janzon L, et al.: Pancreatic carcinoma following gastric resection. Int J Pancreatol 1997;21:219–224.PubMedGoogle Scholar
  132. 132.
    de Martel C, Llosa AE, Friedman GD, Vogelman JH, Orentreich N, Stolzenberg-Solomon RZ, Parsonnet J: Helicobacter pylori infection and development of pancreatic cancer. Cancer Epidemiol Biomarkers Prev 2008;17:1188–1194.PubMedGoogle Scholar
  133. 133.
    Lindkvist B, Johansen D, Borgstrom A, Manjer J: A prospective study of Helicobacter pylori in relation to the risk for pancreatic cancer. BMC Cancer 2008;8:321.PubMedGoogle Scholar
  134. 134.
    Hoefs JC, Renner IG, Askhcavai M, Redeker AG: Hepatitis B surface antigen in pancreatic and biliary secretions. Gastroenterology 1980;79(2):191–194.PubMedGoogle Scholar
  135. 135.
    Yoshimura M, Sakurai I, Shimoda T, Abe K, Okano T, Shikata T: Detection of HBsAg in the pancreas. Acta Pathol Jpn 1981;31(4):711–717.PubMedGoogle Scholar
  136. 136.
    Shimoda T, Shikata T, Karasawa T, Tsukagoshi S, Yoshimura M, Sakurai I: Light microscopic localization of hepatitis B virus antigens in the human pancreas. Possibility of multiplication of hepatitis B virus in the human pancreas. Gastroenterology 1981;81(6):998–1005.PubMedGoogle Scholar
  137. 137.
    Taranto D, Carrato A, Romano M, Maio G, Izzo CM, Del Vecchio BC: Mild pancreatic damage in acute viral hepatitis. Digestion 1989;42(2):93–97.PubMedGoogle Scholar
  138. 138.
    Katakura Y, Yotsuyanagi H, Hashizume K, Okuse C, Okuse N, Nishikawa K et al. Pancreatic involvement in chronic viral hepatitis. World J Gastroenterology 2005;11(23):3508–3513.Google Scholar
  139. 139.
    de Gonzalez AB, Jee SH, Engels EA: No association between hepatitis B and pancreatic cancer in a prospective study in Korea. J Clin Oncol 2009;1:648.Google Scholar
  140. 140.
    Ojajärvi A, Partanen T, Ahlbom A, Boffetta P, Hakulinen T, Jourenkova N, Kauppinen T, Kogevinas M, Vainio H, Weiderpass E, Wesseling C: Risk of pancreatic cancer in workers exposed to chlorinated hydrocarbon solvents and related compounds: a meta-analysis. Am J Epidemiol 2001;153(9):841–850.PubMedGoogle Scholar
  141. 141.
    Ojajärvi A, Partanen T, Ahlbom A, Hakulinen T, Kauppinen T, Weiderpass E, Wesseling C: Estimating the relative risk of pancreatic cancer associated with exposure agents in job title data in a hierarchical Bayesian meta-analysis. Scand J Work Environ Health 2007;33(5):325–335.PubMedGoogle Scholar
  142. 142.
    Gandini S, Lowenfels AB, Jaffee EM, Armstrong TD, Maisonneuve P: Allergies and the risk of pancreatic cancer: a meta-analysis with review of epidemiology and biological mechanisms. Cancer Epidemiol Biomarkers Prev 2005;14(8):1908–1916.PubMedGoogle Scholar
  143. 143.
    Silverman DT, Schiffman M, Everhart J, Goldstein A, Lillemoe KD, Swanson GM, Schwartz AG, Brown LM, Greenberg RS, Schoenberg JB, Pottern LM, Hoover RN, Fraumeni JF, Jr: Diabetes mellitus, other medical conditions and familial history of cancer as risk factors for pancreatic cancer. Brit J Cancer 1999;80(11):1830–1837.PubMedGoogle Scholar
  144. 144.
    Holly EA, Eberle CA, Bracci PM: Prior history of allergies and pancreatic cancer in the San Francisco Bay area. Am J Epidemiology 2003;158(5):432–441.Google Scholar
  145. 145.
    Anderson KE, Johnson TW, Lazovich D, Folsom AR: Association between nonsteroidal anti-inflammatory drug use and the incidence of pancreatic cancer. J Natl Cancer Inst 2002;94(15):1168–1171.PubMedGoogle Scholar
  146. 146.
    Menezes RJ, Huber KR, Mahoney MC, Moysich KB: Regular use of aspirin and pancreatic cancer risk. BMC Public Health 2002;2:18.PubMedGoogle Scholar
  147. 147.
    Schernhammer ES, Kang JH, Chan AT, Michaud DS, Skinner HG, Giovannucci E, Colditz GA, Fuchs CS: A prospective study of aspirin use and the risk of pancreatic cancer in women. J Natl Cancer Inst. 2004;96(1):22–28.PubMedGoogle Scholar
  148. 148.
    Cook NR, Lee IM, Gaziano JM, Gordon D, Ridker PM, Manson JE, Hennekens CH, Buring JE: Low-dose aspirin in the primary prevention of cancer: the Women’s Health Study: a randomized controlled trial. JAMA 2005;294(1):47–55.PubMedGoogle Scholar
  149. 149.
    Larsson SC, Giovannucci E, Bergkvist L, Wolk A: Aspirin and nonsteroidal anti-inflammatory drug use and risk of pancreatic cancer: a meta-analysis. Cancer Epidemiol Biomarkers Prev 2006;15(12):2561–2564.PubMedGoogle Scholar
  150. 150.
    Capurso G, Schünemann HJ, Terrenato I, Moretti A, Koch M, Muti P, Capurso L, Delle Fave G: Meta-analysis: the use of non-steroidal anti-inflammatory drugs and pancreatic cancer risk for different exposure categories. Aliment Pharmacol Ther 2007;26(8):1089–1099.PubMedGoogle Scholar
  151. 151.
    Bonovas S, Filioussi K, Sitaras NM: Statins are not associated with a reduced risk of pancreatic cancer at the population level, when taken at low doses for managing hypercholesterolemia: evidence from a meta-analysis of 12 studies. Am J Gastroenterol 2008;103(10):2646–2651.PubMedGoogle Scholar
  152. 152.
    Jiao L, Mitrou PN, Reedy J, Graubard BI, Hollenbeck AR, Schatzkin A, Stolzenberg-Solomon R: A combined healthy lifestyle score and risk of pancreatic cancer in a large cohort study. Arch Intern Med 2009;169(8):764–770.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Li Jiao
    • 1
  • Donghui Li
    • 2
  1. 1.Division of Cancer Epidemiology and GeneticsNational Cancer InstituteRockvilleUSA
  2. 2.Department of Gastrointestinal Medical OncologyThe University of Texas M.D. Anderson Cancer CenterHoustonUSA

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