Parity and the risk of pancreatic cancer: a nested case-control study

Smoking is the only generally accepted risk factor for pancreatic cancer. Reproductive history has in recent studies been associated with pancreatic cancer, but with contradictory results. In order to evaluate a possible association between age at first birth and the number of births and pancreatic cancer, we conducted a nested case-control study by linking 2 Swedish nationwide registries: the Cancer Registry and The Fertility Registry. Among women born between 1925 and 1970, 1,015 patients with pancreatic cancer were compared with 5,073 age-matched controls. No association between pancreatic cancer and number of births was found. Age at first birth was inversely related with the risk of pancreatic cancer (OR per 5 years = 0.90; 95% CI 0.83-0.97; p = 0.01), an association mainly confined to women with a diagnosis of pancreatic cancer before 50 years of age (OR per 5 years = 0.85; 95% CI 0.73-1.00; p = 0.04). This trend remained after adjustment for parity, but was less prominent. Young age at first birth and high parity in Sweden are, however, associated with an increased frequency of smoking, thus at least some of the increased risk for pancreatic cancer in women with young age at first birth is likely to be explained by smoking acting as a confounder.