Use of moist oral snuff (snus) and pancreatic cancer: Pooled analysis of nine prospective observational studies

• Published in: International journal of cancer Vol. 141; no. 4; pp. 687 - 693
• Main Authors: Araghi, Marzieh, Rosaria Galanti, Maria, Lundberg, Michael, Lager, Anton, Engström, Gunnar, Alfredsson, Lars, Knutsson, Anders, Norberg, Margareta, Sund, Malin, Wennberg, Patrik, Trolle Lagerros, Ylva, Bellocco, Rino, Pedersen, Nancy L., Östergren, Per‐Olof, Magnusson, Cecilia
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 15.08.2017
• Subjects: Adult; Aged; Aged, 80 and over; Cancer; Cancer and Oncology; Cancer och onkologi; Carcinogens; Clinical Medicine; Collaboration; Combustion; Health risk assessment; Health risks; Humans; Incidence; Klinisk medicin; Male; Medical and Health Sciences; Medical research; Medicin och hälsovetenskap; Mens health; Metabolites; Middle Aged; Nicotine; Observational studies; Observational Studies as Topic; Oral cavity; Pancreatic cancer; Pancreatic Neoplasms - epidemiology; Proportional Hazards Models; Prospective Studies; Registers; Risk Assessment; Risk factors; Smoke; Smoking; Snus; Sweden - epidemiology; Tobacco; Tobacco, Smokeless - statistics & numerical data; Young Adult; snus; incidence; pancreatic cancer
• ISSN: 0020-7136; 1097-0215; 1097-0215
• DOI: 10.1002/ijc.30773

While smoking is a well‐established risk factor for pancreatic cancer, the effect of smokeless tobacco is less well understood. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess the association between Swedish snus use and the risk of pancreatic cancer. A total of 424,152 male participants from nine cohort studies were followed up for risk of pancreatic cancer through linkage to health registers. We used shared frailty models with random effects at the study level, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for confounding factors. During 9,276,054 person‐years of observation, 1,447 men developed pancreatic cancer. Compared to never‐snus use, current snus use was not associated with risk of pancreatic cancer (HR 0.96, 95% CI 0.83–1.11) after adjustment for smoking. Swedish snus use does not appear to be implicated in the development of pancreatic cancer in men. Tobacco smoke constituents other than nicotine or its metabolites may account for the relationship between smoking and pancreatic cancer. What's new? While smoking is a well‐established risk factor for pancreatic cancer, the effect of smokeless tobacco is less well understood. Smokeless tobacco like snus yields lower exposure to tobacco carcinogens compared with smoking, because it does not undergo combustion, but delivers an equivalent dose of nicotine. Using pooled individual data from the Swedish Collaboration on Health Effects of Snus Use, here the authors show that Swedish snus use does not appear to be implicated in the development of pancreatic cancer in men. Tobacco smoke constituents other than nicotine or its metabolites may account for the relationship between smoking and pancreatic cancer.