A novel integrated predictive model for pancreatic cancer in the UK Biobank cohort.
Globally, pancreatic cancer (PaCa) is the 12th most common cancer and the 7th leading cause of cancer death. In the UK, PaCa is the 10th most common cancer, with approximately 10,449 people diagnosed annually (year 2016-2018). Unlike the apparent improving survival rates for common cancers such as breast and colorectal cancer, not much progress in terms of survival rate has been made for PaCa. The 1-year survival rate of PaCa is approximately 28%, and the 5-year survival rate is about 6%. However, Cancer Research UK(CRUK) has reported that 37% of pancreatic cancer patients in the UK can be prevented. Due to the emerging increased incidence and poor prognosis of PaCa, it is crucial to confirm the PaCa factors and target people at risk in the UK population.
Previously published literature has reported many potential PaCa risk factors; however, there were some inconsistent findings. Some probable risk factors include ageing, male gender, African American ethnicity, cigarette smoking, heavy alcohol consumption, increased body mass index (BMI), abdominal obesity, chronic pancreatitis, Diabetes mellitus (DM), hepatitis B and cholecystectomy, family history, germline mutation, ABO blood type and genetic predisposition, etc. Some inconclusive potential risk factors include low physical activity, increased consumption of red/processed meat and dairy products, Vitamin D insufficiency, Helicobacter pylori (H. pylori) infection, long-term use of Proton-pump inhibitors(PPI), and Systemic Lupus Erythematosus(SLE) and anti-diabetic drugs, etc. On the other hand, there is a lack of evidence from a large population-based cohort study. Moreover, there was no comprehensive predictive model to combine the lifestyle-related factors, medical-related factors and genetic disposition in the previous survey.
This study would like to investigate the comprehensive PaCa risk factors through the UK Biobank cohort. The UK Biobank is a large population-based prospective cohort study that collected data from around half a million UK people. The recruiting was carried out from 22 centres to ensure that population coverage was dispersed across the UK. This study aims to explore potential risk factors, including lifestyle-related risk factors, medical-related risk factors and genetic predisposition in the UK population. Furthermore, a comprehensive predictive model will be established based on these risk factors, which may provide a reference for clinicians and researchers for the following pancreatic cancer-related risk stratification, prevention, and early detection studies. The findings could also be used as a reference to target people at risk of pancreatic cancer in the UK community to promote the pancreatic cancer prevention program.