review of literature on clinical pancreatology - The Pancreapedia

over 11.5 million individuals. Estimates were based on Poisson regression. RRs <strong>of</strong> tumoursfor individuals with a parental history <strong>of</strong> pancreatic cancer were also estimated. The risk <strong>of</strong>pancreatic cancer was elevated in individuals with a parental history <strong>of</strong> cancers <strong>of</strong> the liver(RR 1.41; 95 % confidence interval 1.10 to 1.81), kidney (RR 1.37; 95 % confidence interval1.06 to 1.76), lung (RR 1.50; 95 % confidence interval 1.27 to 1.79) and larynx (RR 1.98; 95% confidence interval 1.19 to 3.28). Associations were also found between parental history <strong>of</strong>pancreatic cancer and cancers <strong>of</strong> the small intestine, colon, breast, lung, testis and cervix in<strong>of</strong>fspring. There was an increased risk <strong>of</strong> pancreatic cancer associated with early-onsetbreast cancer in siblings. Pancreatic cancer aggregates in families with several types <strong>of</strong>cancer. Smoking may contribute to the familial aggregation <strong>of</strong> pancreatic and lung tumours,and the familial clustering <strong>of</strong> pancreatic and breast cancer could be partially explained byinherited mutations in the BRCA2 gene [329].DanmarkIt was reported the incidence rates <strong>of</strong> pancreatic cancer in Denmark during 61 years <strong>of</strong> dataregistration, from 1943 to 2003 and it was calculated age-standardized, period-specificincidence rates <strong>of</strong> pancreatic cancer. A total <strong>of</strong> 32,654 incident cases <strong>of</strong> pancreatic cancerwere evaluated (male-female ratio, 1.4). The age-standardized incidence rate <strong>of</strong> pancreaticcancer increased steadily in the beginning <strong>of</strong> the study period from 3.75/100,000 personyearsin 1943 to 1947 to the maximum <strong>of</strong> 9.96/100,000 person-years in 1968 to 1972 amongmen and from 2.95 in 1943 to 1947 to the maximum <strong>of</strong> 7.04 in 1978 to 1982 among women.The incidence rates declined between 1968 to 1972 and 1988 to 1992 for men and between1978 to 1982 and 2003 for women. More than 40 percent <strong>of</strong> the tumors were located in thehead <strong>of</strong> the pancreas; 14 percent were localized, 21 percent were regionally spread, and 36percent were metastatic at the time <strong>of</strong> diagnosis. During the period 1978 to 2003, thepercentages <strong>of</strong> histologically or cytologically verified adenocarcinomas remained relativelysteady, approximately 30 percent [330].FranceIn 2006, a total number <strong>of</strong> 149,000 cancer deaths were observed in France, 88,500 in themale population and 60,500 in the female population. In 2005, the number <strong>of</strong> new diagnoses<strong>of</strong> cancer is estimated to be 319,000, 183,000 among men and 136,000 among women. Agestandardisedmortality rates are decreasing for most frequent cancer sites, at least in recentyears, the main exceptions being lung in the female population, and pancreas in both maleand female populations [331].KoreaUsing the population-based cancer registry in Jejudo, it was found that Jejudo had lowerincidence in stomach cancer than other regions in Korea. The aim <strong>of</strong> one study was toevaluate reasons for this difference. Citrus is the leading agricultural production in Jejudo,suggesting that lower cancer incidence in Jejudo could be explained by citrus fruit intake. Itwas evaluated this hypothesis with quantitative systematic <strong>review</strong> (QSR). Stomach cancerincidence was significantly lower, with a summary odds ratio (SOR) after QSR <strong>of</strong> 0.72. Inaddition, the SOR <strong>of</strong> pancreatic cancer tended to be lower at 0.83 (95 % confidence interval0.70 to 0.98). It was suggested that lower cancer incidence in Jejudo could be explained byintake <strong>of</strong> citrus fruits [332].Arctic pancreatic cancerLittle information is available on the incidence and mortality <strong>of</strong> cancer among the Aboriginalpopulation in the Province <strong>of</strong> Québec, Canada. Cancer was likely rare in this population