Is a positive history for a malignant neoplasia in the family a risk factor for pancreatic cancer?

Aims: Smoking, as a risk factor for pancreatic cancer (PC), was shown to accelerate its development. Aim We seeked to find out, whether a positive history for a cancer in the family, other than PC, would also be a risk factor for PC and accelerate its onset.

Methods: All patients (pts) treated at our department for histo- or cytologically proven adenocarcinoma of the pancreas between 1998–2005 were interviewed for their smoking history and history for cancer in the family other than pancreatic cancer. Following our hypothesis, that a risk factor will accelerate the onset of PC, age at diagnosis of PC was modeled as a function of smoking/non-smoking and existence/absence of cancer in the family in a bivariate linear model.

Results: Linear regression among the 67 female pts. revealed an intercept (mean age) of 70.391 years for non-smokers without history of cancer in the family. Smoking female pts without history of cancer in the family acquired PC 9.421 years (95% CI 4.838–14.004) earlier (p=0.0002). The effect of a positive history of cancer in the family was estimated to lead to a 6.201 years (95% CI 1.387–11.014) earlier onset of the disease in non-smoking female pts (p=0.014). The intercept for the 76 men was 63.654 years. Smoking was estimated to reduce age of diagnosis of PC by 6.067 years (95% CI 1.234–11.010, p=0.018). A history of cancer in the family did not affect age of onset of PC in men (p=0.935).

Discussion: Smoking has again been etimated to accelerate onset of PC by approx. 9 years in women and 6 years in men. A positive history for cancer in the family accelerated the onset of PC by 6 years in women. Altogether, an approx. 15 years earlier onset of PC in female smokers with a positive history of cancer in the family could be estimated. The lack of an effect of a positive history of cancer in the family on the onset of PC in men may potentially have been covered by the varying smoking intensity.