Plasma cotinine levels and pancreatic cancer in the EPIC cohort study

Max Leenders, Shu Chun Chuang, Christina C. Dahm, Kim Overvad, Per Magne Ueland, Oivind Midttun, Stein Emil Vollset, Anne Tjønneland, Jytte Halkjær, Mazda Jenab, Françoise Clavel-Chapelon, Marie Christine Boutron-Ruault, Rudolf Kaaks, Federico Canzian, Heiner Boeing, Cornelia Weikert, Antonia Trichopoulou, Christina Bamia, Androniki Naska, Domenico PalliValeria Pala, Amalia Mattiello, Rosario Tumino, Carlotta Sacerdote, Fränzel J B Van Duijnhoven, Petra H M Peeters, Carla H. Van Gils, Eiliv Lund, Laudina Rodriguez, Eric J. Duell, María José Sánchez Pérez, Esther Molina-Montes, José María Huerta Castaño, Aurelio Barricarte, Nerea Larrañaga, Dorthe Johansen, Björn Lindkvist, Malin Sund, Weimin Ye, Kay Tee Khaw, Nicholas J. Wareham, Dominique S. Michaud, Elio Riboli, Wei W. Xun, Naomi E. Allen, Francesca L. Crowe, H. Bas Bueno-De-Mesquita, Paolo Vineis

Research output: Contribution to journalArticlepeer-review

Abstract

Smoking is an established risk factor for pancreatic cancer, previously investigated by the means of questionnaires. Using cotinine as a biomarker for tobacco exposure allows more accurate quantitative analyses to be performed. This study on pancreatic cancer, nested within the European Prospective Investigation into Cancer and Nutrition (EPIC cohort), included 146 cases and 146 matched controls. Using liquid chromatography-mass spectrometry, plasma cotinine levels were analyzed on average 8.0 years before cancer onset (5-95% range: 2.8-12.0 years). The relation between plasma cotinine levels and pancreatic cancer was analyzed with conditional logistic regression for different levels of cotinine in a population of never and current smokers. This was also done for the self-reported number of smoked cigarettes per day at baseline. Every increase of 350 nmol/L of plasma cotinine was found to significantly elevate risk of pancreatic cancer [odds ratio (OR): 1.33, 95% confidence interval (CI): 1.11-1.60]. People with a cotinine level over 1187.8 nmol/L, a level comparable to smoking 17 cigarettes per day, have an elevated risk of pancreatic cancer, compared to people with cotinine levels below 55 nmol/L (OR: 3.66, 95% CI: 1.44-9.26). The results for self-reported smoking at baseline also show an increased risk of pancreatic cancer from cigarette smoking based on questionnaire information. People who smoke more than 30 cigarettes per day showed the highest risk compared to never smokers (OR: 4.15, 95% CI: 1.02-16.42). This study is the first to show that plasma cotinine levels are strongly related to pancreatic cancer.

Original languageEnglish
Pages (from-to)997-1002
Number of pages6
JournalInternational Journal of Cancer
Volume131
Issue number4
DOIs
Publication statusPublished - Aug 15 2012

Keywords

  • cotinine
  • EPIC
  • pancreatic cancer
  • smoking

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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