Temporality of clinical factors associated with pancreatic cancer: a case-control study using linked electronic health records

Abstract Background Pancreatic cancer risk is poorly quantified in relation to the temporal presentation of medical comorbidities and lifestyle. This study aimed to examine this aspect, with possible influence of demographics. Methods We conducted a retrospective case-control study on the ethnically...

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Autores principales:	Abu Z. M. Dayem Ullah, Konstantinos Stasinos, Claude Chelala, Hemant M. Kocher
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Pancreatic cancer Risk factor Comorbidity Lifestyle Ethnicity Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/25ed823fd3654f7f99f113961c10c338
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spelling	oai:doaj.org-article:25ed823fd3654f7f99f113961c10c3382021-11-28T12:27:22ZTemporality of clinical factors associated with pancreatic cancer: a case-control study using linked electronic health records10.1186/s12885-021-09014-w1471-2407https://doaj.org/article/25ed823fd3654f7f99f113961c10c3382021-11-01T00:00:00Zhttps://doi.org/10.1186/s12885-021-09014-whttps://doaj.org/toc/1471-2407Abstract Background Pancreatic cancer risk is poorly quantified in relation to the temporal presentation of medical comorbidities and lifestyle. This study aimed to examine this aspect, with possible influence of demographics. Methods We conducted a retrospective case-control study on the ethnically-diverse population of East London, UK, using linked electronic health records. We evaluated the independent and two-way interaction effects of 19 clinico-demographic factors in patients with pancreatic cancer (N = 965), compared with non-malignant pancreatic conditions (N = 3963) or hernia (control; N = 4355), reported between April 1, 2008 and March 6, 2020. Risks were quantified by odds ratios (ORs) and 95% confidence intervals (CIs) from multivariable logistic regression models. Results We observed increased odds of pancreatic cancer incidence associated with recent-onset diabetes occurring within 6 months to 3 years before cancer diagnosis (OR 1.95, 95% CI 1.25-3.03), long-standing diabetes for over 3 years (OR 1.74, 95% CI 1.32-2.29), recent smoking (OR 1.81, 95% CI 1.36-2.4) and drinking (OR 1.76, 95% CI 1.31-2.35), as compared to controls but not non-malignant pancreatic conditions. Pancreatic cancer odds was highest for chronic pancreatic disease patients (recent-onset: OR 4.76, 95% CI 2.19-10.3, long-standing: OR 5.1, 95% CI 2.18-11.9), amplified by comorbidities or harmful lifestyle. Concomitant diagnosis of diabetes, upper gastrointestinal or chronic pancreatic conditions followed by a pancreatic cancer diagnosis within 6 months were common, particularly in South Asians. Long-standing cardiovascular, respiratory and hepatobiliary conditions were associated with lower odds of pancreatic cancer. Conclusions Several factors are, independently or via effect modifications, associated with higher incidence of pancreatic cancer, but some established risk factors demonstrate similar magnitude of risk measures of developing non-malignant pancreatic conditions. The findings may inform refined risk-stratification strategies and better surveillance for high-risk individuals, and also provide a means for systematic identification of target population for prospective cohort-based early detection research initiatives.Abu Z. M. Dayem UllahKonstantinos StasinosClaude ChelalaHemant M. KocherBMCarticlePancreatic cancerRisk factorComorbidityLifestyleEthnicityNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBMC Cancer, Vol 21, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Pancreatic cancer Risk factor Comorbidity Lifestyle Ethnicity Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Pancreatic cancer Risk factor Comorbidity Lifestyle Ethnicity Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Abu Z. M. Dayem Ullah Konstantinos Stasinos Claude Chelala Hemant M. Kocher Temporality of clinical factors associated with pancreatic cancer: a case-control study using linked electronic health records
description	Abstract Background Pancreatic cancer risk is poorly quantified in relation to the temporal presentation of medical comorbidities and lifestyle. This study aimed to examine this aspect, with possible influence of demographics. Methods We conducted a retrospective case-control study on the ethnically-diverse population of East London, UK, using linked electronic health records. We evaluated the independent and two-way interaction effects of 19 clinico-demographic factors in patients with pancreatic cancer (N = 965), compared with non-malignant pancreatic conditions (N = 3963) or hernia (control; N = 4355), reported between April 1, 2008 and March 6, 2020. Risks were quantified by odds ratios (ORs) and 95% confidence intervals (CIs) from multivariable logistic regression models. Results We observed increased odds of pancreatic cancer incidence associated with recent-onset diabetes occurring within 6 months to 3 years before cancer diagnosis (OR 1.95, 95% CI 1.25-3.03), long-standing diabetes for over 3 years (OR 1.74, 95% CI 1.32-2.29), recent smoking (OR 1.81, 95% CI 1.36-2.4) and drinking (OR 1.76, 95% CI 1.31-2.35), as compared to controls but not non-malignant pancreatic conditions. Pancreatic cancer odds was highest for chronic pancreatic disease patients (recent-onset: OR 4.76, 95% CI 2.19-10.3, long-standing: OR 5.1, 95% CI 2.18-11.9), amplified by comorbidities or harmful lifestyle. Concomitant diagnosis of diabetes, upper gastrointestinal or chronic pancreatic conditions followed by a pancreatic cancer diagnosis within 6 months were common, particularly in South Asians. Long-standing cardiovascular, respiratory and hepatobiliary conditions were associated with lower odds of pancreatic cancer. Conclusions Several factors are, independently or via effect modifications, associated with higher incidence of pancreatic cancer, but some established risk factors demonstrate similar magnitude of risk measures of developing non-malignant pancreatic conditions. The findings may inform refined risk-stratification strategies and better surveillance for high-risk individuals, and also provide a means for systematic identification of target population for prospective cohort-based early detection research initiatives.
format	article
author	Abu Z. M. Dayem Ullah Konstantinos Stasinos Claude Chelala Hemant M. Kocher
author_facet	Abu Z. M. Dayem Ullah Konstantinos Stasinos Claude Chelala Hemant M. Kocher
author_sort	Abu Z. M. Dayem Ullah
title	Temporality of clinical factors associated with pancreatic cancer: a case-control study using linked electronic health records
title_short	Temporality of clinical factors associated with pancreatic cancer: a case-control study using linked electronic health records
title_full	Temporality of clinical factors associated with pancreatic cancer: a case-control study using linked electronic health records
title_fullStr	Temporality of clinical factors associated with pancreatic cancer: a case-control study using linked electronic health records
title_full_unstemmed	Temporality of clinical factors associated with pancreatic cancer: a case-control study using linked electronic health records
title_sort	temporality of clinical factors associated with pancreatic cancer: a case-control study using linked electronic health records
publisher	BMC
publishDate	2021
url	https://doaj.org/article/25ed823fd3654f7f99f113961c10c338
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Temporality of clinical factors associated with pancreatic cancer: a case-control study using linked electronic health records

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