Association between a combined lifestyle exposure index and age at pancreatic cancer diagnosis: a hospital-based retrospective study.
6 affiliations
- 1Graduate Institute of Public Health, College of Public Health, China Medical University, Taichung, 406040, Taiwan.
- 2Division of Gastroenterology and Hepatology, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei City, 24352, Taiwan.
- 3Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, 89154, USA.
- 4Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, 824005, Taiwan.
- 5Department of Surgery, China Medical University Hospital, Taichung, 404332, Taiwan.
- 6Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, 406040, Taiwan. [email protected].
Abstract
Background
Pancreatic cancer is a highly lethal malignancy, and its incidence is increasing among younger individuals. Although smoking, alcohol use, and unhealthy diet are established risk factors, the cumulative impact of multiple lifestyle exposures on age at diagnosis remains unclear. This study aimed to estimate the combined burden of lifestyle and environmental risks associated with the timing of pancreatic cancer diagnosis.Methods
We conducted a hospital-based retrospective case-only study including 134 patients diagnosed with pancreatic cancer between 2020 and 2025. Data on family history of pancreatic cancer, cigarette smoking, alcohol consumption, dietary patterns, exercise, and occupational chemical exposure were collected through structured interviews and medical record reviews. Cox proportional hazards models using age at diagnosis as the time scale were used to evaluate associations between exposures and earlier diagnosis. Lifestyle factors were integrated into a cumulative exposure index and analyzed using Cox models with adjustment for the remaining covariates.Results
The mean age at diagnosis was 64.8 years. A significant difference in age at diagnosis was observed across smoking categories, with current smokers having the youngest mean age, whereas no significant difference was observed across alcohol consumption categories. Patients with triple exposure had the youngest mean age at diagnosis (55.5 years), followed by those with double (63.5 years), single (64.8 years), and no (69.0 years) exposures. Compared with no exposure, single, double, and triple exposures were associated with progressively higher hazards of earlier diagnosis (HR = 1.79, 95% CI: 1.14-2.81, p = 0.011; HR = 2.97, 95% CI: 1.67-5.28, p < 0.001; and HR = 6.66, 95% CI: 3.35-13.22, p < 0.001, respectively).Conclusions
Our findings indicate a significant association between a higher combined exposure index and earlier age at pancreatic cancer diagnosis. This exposure-response gradient suggests that a greater accumulation of adverse lifestyle exposures corresponds to earlier age at diagnosis among affected patients.Trial registration
Not applicable.
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BibTeX
@article{lee2026association,
title = {{Association between a combined lifestyle exposure index and age at pancreatic cancer diagnosis: a hospital-based retrospective study.}},
author = {Fu-Jen Lee and Lung-Chang Chien and Jaw-Town Lin and Chun-Chieh Yeh and Ro-Ting Lin},
journal = {BMC gastroenterology},
year = {2026},
month = sep,
doi = {10.1186/s12876-026-05297-0},
url = {https://europepmc.org/article/MED/42958510},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association between a combined lifestyle exposure index and age at pancreatic cancer diagnosis: a hospital-based retrospective study.
AU - Fu-Jen Lee
AU - Lung-Chang Chien
AU - Jaw-Town Lin
AU - Chun-Chieh Yeh
AU - Ro-Ting Lin
PY - 2026
DA - 2026/09/10
JO - BMC gastroenterology
DO - 10.1186/s12876-026-05297-0
UR - https://europepmc.org/article/MED/42958510
AB - Background Pancreatic cancer is a highly lethal malignancy, and its incidence is increasing among younger individuals. Although smoking, alcohol use, and unhealthy diet are established risk factors, the cumulative impact of multiple lifestyle exposures on age at diagnosis remains unclear. This study aimed to estimate the combined burden of lifestyle and environmental risks associated with the timing of pancreatic cancer diagnosis.Methods We conducted a hospital-based retrospective case-only study including 134 patients diagnosed with pancreatic cancer between 2020 and 2025. Data on family history of pancreatic cancer, cigarette smoking, alcohol consumption, dietary patterns, exercise, and occupational chemical exposure were collected through structured interviews and medical record reviews. Cox proportional hazards models using age at diagnosis as the time scale were used to evaluate associations between exposures and earlier diagnosis. Lifestyle factors were integrated into a cumulative exposure index and analyzed using Cox models with adjustment for the remaining covariates.Results The mean age at diagnosis was 64.8 years. A significant difference in age at diagnosis was observed across smoking categories, with current smokers having the youngest mean age, whereas no significant difference was observed across alcohol consumption categories. Patients with triple exposure had the youngest mean age at diagnosis (55.5 years), followed by those with double (63.5 years), single (64.8 years), and no (69.0 years) exposures. Compared with no exposure, single, double, and triple exposures were associated with progressively higher hazards of earlier diagnosis (HR = 1.79, 95% CI: 1.14-2.81, p = 0.011; HR = 2.97, 95% CI: 1.67-5.28, p < 0.001; and HR = 6.66, 95% CI: 3.35-13.22, p < 0.001, respectively).Conclusions Our findings indicate a significant association between a higher combined exposure index and earlier age at pancreatic cancer diagnosis. This exposure-response gradient suggests that a greater accumulation of adverse lifestyle exposures corresponds to earlier age at diagnosis among affected patients.Trial registration Not applicable.
SN - 1471-230X
ER -