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Factors that affect risk for pancreatic disease in the general population: a systematic review and meta-analysis of prospective cohort studies.

Abstract

BACKGROUND & AIMS

Pancreatic diseases place significant burdens on health care systems worldwide. However, there is lack of agreement about which factors increase or reduce risk for pancreatic disease. We reviewed high-quality studies of factors that affect risk for pancreatic diseases in the general population.

METHODS

We searched 3 databases (Medline, Embase, and Scopus) for prospective cohort studies of modifiable risk and/or protective factors for acute pancreatitis, chronic pancreatitis, and pancreatic cancer in adult populations. Factors that were investigated in 2 or more studies were assessed by meta-analysis if the required data were available. Subgroup analyses were performed when appropriate. Outcome measures were relative risk (RR) and 95% confidence interval (CI).

RESULTS

Our analysis included 51 population-based studies with more than 3 million individuals and nearly 11,000 patients with pancreatic diseases. A total of 31 different factors were investigated. Current tobacco use was the single most important risk factor for pancreatic diseases (RR, 1.87; 95% CI, 1.54-2.27), followed by obesity (RR, 1.48; 95% CI, 1.15-1.92) and heavy use of alcohol (RR, 1.37; 95% CI, 1.19-1.58). Tobacco and heavy use of alcohol had bigger effects on risk of acute pancreatitis and chronic pancreatitis than pancreatic cancer. Vegetable consumption (RR, 0.71; 95% CI, 0.57-0.88) and fruit consumption (RR, 0.73; 95% CI, 0.60-0.90) provided the greatest degree of protection against pancreatic diseases on the basis of meta-analyses. Vegetable consumption had stronger association with protection against acute pancreatitis and fruit consumption with protection against pancreatic cancer.

CONCLUSIONS

On the basis of systematic review and meta-analysis, current tobacco use, obesity, and heavy use of alcohol are associated with significant increases in risk for pancreatic diseases. Vegetables and fruit consumption are associated with reduced risk for pancreatic diseases. Prevention strategies for acute pancreatitis, chronic pancreatitis, and pancreatic cancer should consider these factors.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Surgery, University of Auckland, Auckland, New Zealand.

    ,

    Department of Surgery, University of Auckland, Auckland, New Zealand.

    ,

    Department of Surgery, University of Auckland, Auckland, New Zealand.

    Department of Surgery, University of Auckland, Auckland, New Zealand. Electronic address: max.petrov@gmail.com.

    Source

    MeSH

    Alcoholism
    Cohort Studies
    Humans
    Obesity
    Pancreatic Neoplasms
    Pancreatitis
    Prospective Studies
    Risk Factors
    Smoking

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    24509242

    Citation

    Alsamarrai, Ammar, et al. "Factors That Affect Risk for Pancreatic Disease in the General Population: a Systematic Review and Meta-analysis of Prospective Cohort Studies." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 12, no. 10, 2014, pp. 1635-44.e5; quiz e103.
    Alsamarrai A, Das SL, Windsor JA, et al. Factors that affect risk for pancreatic disease in the general population: a systematic review and meta-analysis of prospective cohort studies. Clin Gastroenterol Hepatol. 2014;12(10):1635-44.e5; quiz e103.
    Alsamarrai, A., Das, S. L., Windsor, J. A., & Petrov, M. S. (2014). Factors that affect risk for pancreatic disease in the general population: a systematic review and meta-analysis of prospective cohort studies. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 12(10), pp. 1635-44.e5; quiz e103. doi:10.1016/j.cgh.2014.01.038.
    Alsamarrai A, et al. Factors That Affect Risk for Pancreatic Disease in the General Population: a Systematic Review and Meta-analysis of Prospective Cohort Studies. Clin Gastroenterol Hepatol. 2014;12(10):1635-44.e5; quiz e103. PubMed PMID: 24509242.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Factors that affect risk for pancreatic disease in the general population: a systematic review and meta-analysis of prospective cohort studies. AU - Alsamarrai,Ammar, AU - Das,Stephanie L M, AU - Windsor,John A, AU - Petrov,Maxim S, Y1 - 2014/02/05/ PY - 2014/01/14/received PY - 2014/01/22/accepted PY - 2014/2/11/entrez PY - 2014/2/11/pubmed PY - 2015/5/28/medline KW - Acute Pancreatitis KW - Alcohol KW - Chronic Pancreatitis KW - Obesity KW - Pancreatic Cancer KW - Tobacco SP - 1635-44.e5; quiz e103 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 12 IS - 10 N2 - BACKGROUND & AIMS: Pancreatic diseases place significant burdens on health care systems worldwide. However, there is lack of agreement about which factors increase or reduce risk for pancreatic disease. We reviewed high-quality studies of factors that affect risk for pancreatic diseases in the general population. METHODS: We searched 3 databases (Medline, Embase, and Scopus) for prospective cohort studies of modifiable risk and/or protective factors for acute pancreatitis, chronic pancreatitis, and pancreatic cancer in adult populations. Factors that were investigated in 2 or more studies were assessed by meta-analysis if the required data were available. Subgroup analyses were performed when appropriate. Outcome measures were relative risk (RR) and 95% confidence interval (CI). RESULTS: Our analysis included 51 population-based studies with more than 3 million individuals and nearly 11,000 patients with pancreatic diseases. A total of 31 different factors were investigated. Current tobacco use was the single most important risk factor for pancreatic diseases (RR, 1.87; 95% CI, 1.54-2.27), followed by obesity (RR, 1.48; 95% CI, 1.15-1.92) and heavy use of alcohol (RR, 1.37; 95% CI, 1.19-1.58). Tobacco and heavy use of alcohol had bigger effects on risk of acute pancreatitis and chronic pancreatitis than pancreatic cancer. Vegetable consumption (RR, 0.71; 95% CI, 0.57-0.88) and fruit consumption (RR, 0.73; 95% CI, 0.60-0.90) provided the greatest degree of protection against pancreatic diseases on the basis of meta-analyses. Vegetable consumption had stronger association with protection against acute pancreatitis and fruit consumption with protection against pancreatic cancer. CONCLUSIONS: On the basis of systematic review and meta-analysis, current tobacco use, obesity, and heavy use of alcohol are associated with significant increases in risk for pancreatic diseases. Vegetables and fruit consumption are associated with reduced risk for pancreatic diseases. Prevention strategies for acute pancreatitis, chronic pancreatitis, and pancreatic cancer should consider these factors. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/24509242/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(14)00183-9 DB - PRIME DP - Unbound Medicine ER -