One in five pancreatic cancers attributable to smoking

Cate Swannell
Med J Aust
Published online: 10 March 2019

ALMOST 22% of the future burden of pancreatic cancer in Australia is attributable to current and former smoking, according to the authors of research published online today by the Medical Journal of Australia.

Pancreatic cancer is the fourth leading cause of cancer-related death in Australian men, and the fifth leading cause in women, with a 5-year survival rate of under 10%.

Because pancreatic cancer presents late, when the disease is at an advanced stage, “primary prevention is the best control strategy”, said the authors, led by Dr Maarit Laaksonen, Senior Research Fellow and Senior Lecturer in Health Data Science at UNSW’s Centre for Big Data Research in Health.

This study is the first to attempt to estimate the future pancreatic cancer burden attributable to tobacco smoking in Australia.

The authors analysed data from 365 084 adults from Australian cohort studies linked to national cancer and death registries to identify cases of pancreatic cancer and deaths. There were 604 incident cases of pancreatic cancer during the first 10 years of follow-up. Current and recent smoking explained 21.7% and current smoking alone explained 15.3% of future pancreatic cancer burden (5500 cases over the next 10 years).

“This proportion of the burden would be avoidable over 25 years were current smokers to quit and there were no new smokers, as pancreatic cancer risk remains elevated for 15 years after stopping smoking,” the authors wrote.

They also found that the burden attributable to current smoking was greater for men (23.9%) than for women (7.2%) and for those under 65 (19.0%) than for older people (6.6%). There were no independent relationships between body mass index or alcohol consumption and pancreatic cancer. Former smokers who had quit less than 15 years ago were at higher risk of pancreatic cancer than never smokers, but not those who had quit more than 15 years ago.

“We estimate that 21.7% of future pancreatic cancers in Australia are attributable to current and recent smoking,” Laaksonen and colleagues wrote. “The preventable burden attributable to current smoking is 15.3% of all cases, or 5500 cases over the next 10 years; the corresponding figures for lung cancers are 53.7% (74 500 cases)10 and for colorectal cancers 3.9% (7100 cases).

“Reducing the uptake and prevalence of smoking in Australia further will substantially reduce the future burden of pancreatic cancer, especially among men,” they concluded.

  • Cate Swannell



remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.