Background/Objectives:Worldwide, men experience a higher incidence of pancreatic cancer (PC) than women.Methods:To increase understanding of the underlying reasons for this sex-related difference, we analysed general and sex-related risk factors for PC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (women/men No. = 293,682/136,728; 717/577 PC-cases).Results:Cox proportional hazards models showed a 1.31-fold higher risk of developing PC for men compared to women (HR, 95% CI 1.15–1.49) after adjustment for age, smoking history, BMI, diabetes, and alcohol consumption. Associations of PC with established risk factors did not differ between men and women, with the exception of a greater risk of PC among women with greater attained body height, meat consumption and cigarettes smoked (1.12 (1.05–1.19) per 5 cm, 1.18 (1.02–1.36) per 100 g/d, 1.42 (1.27–1.59) per 10/d; respectively). Among child-bearing women, long cumulative duration of breastfeeding was inversely associated with risk of PC (HR 0.74, 95% CI 0.61–0.89) for >5.7 months of breastfeeding (median) relative to ≤5.7 months and among HRT users, cumulative duration of HRT use was inversely associated with PC risk (HR 0.71, 95% CI 0.53–0.95, >2.4 versus ≤2.4 years). Further reproductive and hormonal factors, such as age at menarche, number of full-term pregnancies, age at menopause, or use of oral contraceptives, were not significantly associated with PC risk.Conclusions:Pooled analyses of large cohort studies are needed to confirm these results, and detailed data on the type and intensity of HRT are required to better evaluate its effect.
背景/目的：全球范围内，男性胰腺癌（PC）的发病率高于女性。方法：为深入理解这一性别差异的内在原因，我们在欧洲癌症与营养前瞻性调查（EPIC）队列中（女性/男性人数=293,682/136,728；胰腺癌病例717/577例）分析了胰腺癌的一般风险因素及性别相关风险因素。结果：经年龄、吸烟史、体重指数、糖尿病及饮酒情况调整后的Cox比例风险模型显示，男性罹患胰腺癌的风险是女性的1.31倍（风险比HR，95%置信区间1.15–1.49）。除特定因素外，已明确的胰腺癌风险因素在男女性别间未呈现差异。值得注意的是，女性身高每增加5厘米、每日肉类摄入量每增加100克、每日吸烟量每增加10支，其胰腺癌风险分别增加1.12倍（1.05–1.19）、1.18倍（1.02–1.36）和1.42倍（1.27–1.59）。在育龄女性中，累计哺乳时长超过5.7个月（中位数）者相较于哺乳时长≤5.7个月者，其胰腺癌风险显著降低（HR 0.74，95% CI 0.61–0.89）；在激素替代疗法（HRT）使用者中，累计使用时长超过2.4年者相较于使用时长≤2.4年者，胰腺癌风险亦显著下降（HR 0.71，95% CI 0.53–0.95）。其他生殖与激素相关因素（如初潮年龄、足月妊娠次数、绝经年龄或口服避孕药使用情况）与胰腺癌风险无显著关联。结论：需通过大型队列研究的汇总分析验证上述结果，并需要获取激素替代疗法的具体类型与使用强度等详细数据以更准确评估其影响。
肿瘤(癌症)患者之家