Exocrine pancreatic cancer, cigarette smoking, and diabetes mellitus: A case-control study in Northern Italy

Luigina Bonelli, Hugo Aste, Paolo Bovo, Giorgio Cavallini, Martina Felder, Riccardo Gusmaroli, Erminio Morandini, Paolo Ravelli, Romolo Briglia, Lucio Lombardo, Alberto De Micheli, Vittorio Pugliese

Research output: Contribution to journalArticlepeer-review


The role of cigarette smoking and diabetes mellitus as risk factors for exocrine pancreatic cancer (PC) was investigated in a hospital based case-control study. Current smokers were at increased risk for PC (OR = 2.36, 95% CI 1.53-3.63): the magnitude of the risk was related to the lifetime amount of smoking (χ 2 trend = 17.00; P <0.0001). Among former smokers, after 15 years from ceasing smoking, the risk for PC dropped to the level of a lifetime nonsmoker, whichever the lifetime smoking amount. Diabetes was associated with a 2.89-fold increased risk for PC (95% CI 1.71-4.86): the risk was 4.76 (95% CI 1.99-11.53) for diabetes diagnosed up to 2 years before the diagnosis of PC and dropped to 2.07 (95% CI 1.02-4.20) for diabetes diagnosed more than 5 years before PC. The risk for PC was estimated according to the treatment used to control diabetes: it was 6.49 (95% CI 2.28-18.48) for insulin treated diabetes and 2.12 (95% CI 1.16-3.87) for diabetes treated with oral hypoglycemic drugs. The risk of PC for diabetes treated for more than 5 years before the diagnosis of PC was 6.21 (95% CI 1.61-23.96) for patients treated with insulin and 1.21 (95% CI 0.50-2.92) for those treated with oral hypoglycemic drugs: the type of treatment needed to control the disease may discriminate between the diabetes that represents a consequence of cancer from the diabetes that could represent an etiological cofactor. More studies are needed to clarify whether long-lasting insulin-treated diabetes is an etiological co-factor in PC.

Original languageEnglish
Pages (from-to)143-149
Number of pages7
Issue number2
Publication statusPublished - Aug 2003


  • Cigarette smoking
  • Diabetes mellitus
  • Exocrine pancreatic cancer
  • Insulin
  • Oral antidiabetics agents

ASJC Scopus subject areas

  • Gastroenterology
  • Endocrinology


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