Establishment of risk model for pancreatic cancer in Chinese Han population

Table 1 Diagnostic standards for pancreatic cancer

A. Confirmed diagnosis by pathology

B. A valid confirmation requires at least 2 of the following listed items of imaging tests

(1) Ultrasound indicates there are low-density area in pancreas, as well as pancreatic duct dilation and common bile duct and gall bladder swelling

(2) CT indicates local enlargement and mass occupying lesion in pancreas

(3) ERCP indicates discontinuity of pancreatic duct, having mouse-tail ending, stiff and irregular duct wall, or any pull sign and double-duct sign

(4) MREP indicates there are stenosis and dilation in pancreatic duct and/or bile duct and space-occupying lesion in pancreas

(5) EUS indicates there is low-density, occupying lesion in pancreas

(6) IDUS

(7) Angiography

(8) PET

C. Palpable mass in surgery and at least an item of radiology evidence

ERCP: Endoscopic retrograde cholangiopancreatography MREP: Magnetic resonance cholangiopancreatography EUS: Endoscopic ultrasound sonography IDUS: Intraductal ultrasound sonography PET: Positron Emission Tomography

Table 2 Inclusion and exclusion criteria for patients and controls

Inclusion criteria		Exclusion criteria
Patients	(1) The patient voluntarily took part in this research; agreed to take necessary clinical examinations and answer epidemiological questionnaire survey; and give consent to the publication of research data.	(1) The patient did not agree upon the conditions to participate in the study or the patient information was not available at the inclusion time.
	(2) Diagnosed by the pancreatic cancer team from PUMCH.	(2) Not diagnosed by the pancreatic cancer team from PUMCH.
	(3)Clinical examination and epidemiological investigation were acceptable for the patient’s condition.	(3) The patient’s condition did not allow the clinical examination and epidemiological investigation.
	(4) Patient was diagnosed for pancreatic cancer between 2002 and 2004.	(4) The patient was not diagnosed for pancreatic cancer for the first time between 2002 and 2004.
	(5) Patients did not undergo radiotherapy and anticancer therapy before surgery, and did not have other primary tumors.	(5) Patients whose pancreatic tumor was a metastatic carcinoma or who had other tumors.
	(6) Patients belonged to Han nationality.	(6) Patients were not from Han nationality.
Controls	(1) The person voluntarily took part in this research; agreeed to take necessary clinical examinations and answer epidemiological questionnaire survey; and give consent to the publication of research data.	(1) The person did not agree upon the conditions to participate in the study or the person’s information was not available at the inclusion time.
	(2) The person did not have any kind of tumor.	(2) Person had any kind of malignant tumor.
	(3) The person matched with the patients for gender and age (±5 years).	(3) Person suffered from severe coronary heart disease or stroke.
	(4) Being the resident of Beijing or its peripheral area for at least 5 years.	(4) Person did not match with the patient group for gender and age (±5 years).
	(5) Han nationality.	(5) Not from Han nationality.

Table 3 Demographic characters of patients and controls

	Patients		Controls		χ2	P
	n (%)		n (%)
Age (yr)
Male ≤ 50	16	(20.8)	36	(31.9)
50-59	17	(22.1)	27	(23.9)	3.6583	0.1606
≥ 60	44	(57.1)	50	(44.3)
Female ≤ 50	9	(21.4	28	(29.5)
50-59	8	(19.1)	26	(27.4)	3.1297	0.2091
≥ 60	25	(59.5)	41	(43.2)
Gender Male	77	(64.7)	113	(54.3)
Female	42	(35.3)	95	(45.7)	3.3496	0.0672
Marriage status
Married	115	(96.6)	183	(87.9)
Divorced	0	(0)	7	(3.4)
Widowed	4	(3.4)	16	(7.7)	8.093	0.082
Separated	0	(0)	1	(0.5)
Spinsterhood	0	(0)	1	(0.5)

Table 4 Benign digestive diseases in patients and controls

Diseases	Patients				Controls				P
	n	Yes	No	Not stated	n	Yes	No	Not stated
Chronic pancreatitis	119	2.5	95.0	2.5	205	0.5	99.5	0	0.012
Acute pancreatitis	119	0	98.3	1.7	205	0	100	0	0.06
Cholelithiasis	119	10.01	89.1	0.8	205	4.9	95.1	0	0.08
Cholecystitis	118	9.3	87.3	3.4	205	0.5	99.5	0	<0.0001
Cholecystectomy	119	3.4	95.8	0.8	205	2.9	97.1	0	0.41

Table 5 Clinical symptoms of patients and controls

Symptom	Symptom duration (mo)a	Patients				Controls				P
		n	Yes	No	Not stated	n	Yes	No	Not stated
Anorexia	2	118	45.8	54.2	0	203	0.5	99.5	0	<0.0001
Epigastric pain	3	119	60.5	38.7	0.8	181	2.2	97.8	0	<0.0001
Backache	2	119	32.8	66.4	0.8	205	2.0	98.1	0	<0.0001
Hypogastralgia	3	119	16.0	82.4	1.7	205	3.4	96.6	0	<0.0001
Abdominal pain	2	119	38.7	61.3	0	205	4.9	95.1	0	<0.0001
Jaundice	1	119	42.0	58.0	0	205	0.5	99.5	0	<0.0001
Skin itch	1	119	13.5	86.6	0	205	8.7	91.3	0	0.0032
Weight loss	3	119	76.5	22.7	0.8	205	2.4	97.6	0	<0.0001

Table 6 Risk scoring model for pancreatic cancer

Risk factor	Criteria	Points
Gender	Male	2
Age (yr)	> 60	7
Alcohol drinking	> 20 drink-yr	4
Smoking	> 17 pack-yr	5
Diabetic mellitus history		17
High meat consumption		7
Family history of pancreatic cancer		15
Chronic pancreatitis		12
Cholelithiasis history		8
Cholecystitis history		1
Anorexia		25
Epigastric pain		25
Weight loss		37
Jaundice		30