An absolute risk model to identify individuals at elevated risk for pancreatic cancer in the general population

PLoS One. 2013 Sep 13;8(9):e72311. doi: 10.1371/journal.pone.0072311. eCollection 2013.

Abstract

Purpose: We developed an absolute risk model to identify individuals in the general population at elevated risk of pancreatic cancer.

Patients and methods: Using data on 3,349 cases and 3,654 controls from the PanScan Consortium, we developed a relative risk model for men and women of European ancestry based on non-genetic and genetic risk factors for pancreatic cancer. We estimated absolute risks based on these relative risks and population incidence rates.

Results: Our risk model included current smoking (multivariable adjusted odds ratio (OR) and 95% confidence interval: 2.20 [1.84-2.62]), heavy alcohol use (>3 drinks/day) (OR: 1.45 [1.19-1.76]), obesity (body mass index >30 kg/m(2)) (OR: 1.26 [1.09-1.45]), diabetes >3 years (nested case-control OR: 1.57 [1.13-2.18], case-control OR: 1.80 [1.40-2.32]), family history of pancreatic cancer (OR: 1.60 [1.20-2.12]), non-O ABO genotype (AO vs. OO genotype) (OR: 1.23 [1.10-1.37]) to (BB vs. OO genotype) (OR 1.58 [0.97-2.59]), rs3790844(chr1q32.1) (OR: 1.29 [1.19-1.40]), rs401681(5p15.33) (OR: 1.18 [1.10-1.26]) and rs9543325(13q22.1) (OR: 1.27 [1.18-1.36]). The areas under the ROC curve for risk models including only non-genetic factors, only genetic factors, and both non-genetic and genetic factors were 58%, 57% and 61%, respectively. We estimate that fewer than 3/1,000 U.S. non-Hispanic whites have more than a 5% predicted lifetime absolute risk.

Conclusion: Although absolute risk modeling using established risk factors may help to identify a group of individuals at higher than average risk of pancreatic cancer, the immediate clinical utility of our model is limited. However, a risk model can increase awareness of the various risk factors for pancreatic cancer, including modifiable behaviors.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • ABO Blood-Group System
  • Adenocarcinoma / complications
  • Adenocarcinoma / epidemiology*
  • Adenocarcinoma / ethnology
  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Diabetes Complications / epidemiology*
  • Diabetes Complications / ethnology
  • Europe / epidemiology
  • European Continental Ancestry Group
  • Female
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Models, Statistical*
  • Odds Ratio
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / epidemiology*
  • Pancreatic Neoplasms / ethnology
  • ROC Curve
  • Risk Factors
  • Smoking
  • United States / epidemiology

Substances

  • ABO Blood-Group System

Grant support