| Objective Pancreatic cancer(PC)is a highly invasive malignant tumor commonly seen in the digestive system and has a lethal risk.It is also the leading cause of cancer death worldwide,and its global burden has more than doubled in the past 25 years.Due to the special anatomical location of the pancreas,the disease has no early symptoms typical and can quickly invade surrounding tissues and organs.When diagnosed with PC-specific clinical symptoms,it is usually in the late stage of the disease,so it is one of the most deadly cancers.In order to determine the important factors in the occurrence and development of PC,we explored the risk factors of PC through the data of 500,000 prospective population cohorts in the UK Biobank(UKB),hoping to provide feasible strategies for the clinical prevention and treatment of PC.Methods The data of 500,000 participants from 2006 to 2010 were extracted from the UKB database.According to the age and sex of PC patients,1: 10 matched non-PC patients were the control group,and the clinical characteristics of the PC group and control group were summarized.The independent risk factors of PC were analyzed by univariate logistic regression model and multivariate binary stepwise regression model.We calculated the odds ratio(OR)of each risk factor and the 95% confidence interval(CI)and estimated the risk factor population attribution risk(PAR)based on Bruzzi et al.When P<0.05,the difference was statistically significant.Results1.A total of 1538 PC patients and 15380 control patients were included for comparison.The number of PC patients accounted for 9 % of the total number of patients in the study.The median age of the patients in the PC group was 62 years old.There were 809 male patients,accounting for 52.6%,and 729 female patients,accounting for 47.4%.The ratio of males to females was 1.12:1,and most of them were white(more than 90%).2.Compared with the control group,the Townsend index,smoking history,BMI,and the prevalence of hypertension,type I diabetes,type II diabetes,acute pancreatitis,and chronic pancreatitis in the PC group were significantly different from those in the control group(P<0.05),whereas there were no significant differences between the two groups in terms of race,education,and drinking history(P>0.05).There was no significant difference in the intake frequency of vegetables,fruits,grains,processed meat,poultry,pork,and tea between the PC group and the control group(P>0.05).Laboratory indicator: There were significant differences in TBIL,GGT,HDL,ALT,LDL,TG,Cr,CRP,Hb A1 c,and FPG levels between the two groups(P<0.05),but not in IBIL,ALB,AST,TC,UA levels(P>0.05).3.Univariate logistic regression analysis showed that Townsend index,smoking history,BMI,history of hypertension,history of diabetes(type I and type II diabetes),history of acute pancreatitis,history of chronic pancreatitis,and intake of processed meat and poultry less than 5 times/week were associated with the occurrence of PC(P<0.05).Among the laboratory test indicators,TBIL,ALT,GGT,CRP,HDL,TC,TG,FPG,LDL,and Hb A1 c levels were also associated with the occurrence of PC(P<0.05).4.Multivariate stepwise regression analysis showed that Townsend index (OR=1.020,95%CI:1.001-1.040),smoking history(OR=1.182,95%CI:1.048-1.333), type I diabetes history(OR=1.890,95%CI:1.228-2.910),type II diabetes history (OR=2.109,95%CI:1.794-2.481),acute pancreatitis history(OR=5.266,95%CI:3.679-7.538),chronic pancreatitis history(OR=17.345,95%CI:8.820-34.111)wereindependent risk factors for PC.And the distribution of risk factors in men andwomen is similar to the overall population.5.After multivariate adjustment,in the UKB population,the population attributable risk of smoking history,type I diabetes history,type II diabetes history,acute pancreatitis history,chronic pancreatitis history,and both acute and chronic pancreatitis history were 8.4%,19.86%,12.37%,6.50%,7.30%,and 7.13%,respectively.Conclusion PC has strong invasiveness,high malignancy,and poor prognosis.The incidence of PC is low,and there is little difference between the sexes.The results of multivariate analysis in this study showed that Townsend index,smoking history,history of type I and type II diabetes,history of acute pancreatitis,and history of the chronic pancreas were independent risk factors for PC.Calculating the population-attributable risk of each risk factor is helpful for the clinical identification of high-risk groups and early individualized intervention.It is also helpful for the early diagnosis and treatment of PC,which is of great significance to reduce the incidence and mortality of PC and prolong the survival time of patients. |
