A Multifactorial Model for Pancreatic Cancer in Man

In the past 30 years, the incidence of pancreatic cancer has increased substantially. The disease now causes more deaths than all other malignant neoplasms, except those of the colorectal region, lung, and breast. A study in over 115 hospitals in five metropolitan areas showed that males with pancreatic cancer were more often employed in the dry cleaning business or in occupations involving close exposure to gasoline, increasing the risk for pancreatic cancer up to five times. Females at risk for pancreatic cancer were more likely to smoke cigarettes, to have uterine myomas, and to have undergone oophorectomy or spontaneous abortions. Generally, these patients were of higher social class and drank more wine and decaffeinated coffee than demographically similar controls. Assessment of the effects of several factors showed that relative risks increased 34-fold among females and nearly sixfold among males. While no single factor accounts for the preponderance of pancreatic cancer, a combination of factors—each associated with a relatively small risk enhancement—may very well do so. (JAMA1981;245:147-152)