Background: Experimental studies suggest that iron overload might increase pancreatic cancer risk. We evaluated whether prediagnostic hemochromatosis and iron-overload diseases, including sideroblastic and congenital dyserythropoietic anemias, and non–alcoholic-related chronic liver disease (NACLD) were associated with pancreatic cancer risk in older adults. Methods: We conducted a population-based, case–control study within the U.S. Surveillance, Epidemiology, and End Results Program (SEER)-Medicare linked data. Incident primary pancreatic cancer cases were adults > 66 years. Controls were alive at the time cases were diagnosed and matched to cases (4:1 ratio) by age, sex, and calendar year. Hemochromatosis, iron-overload anemias, and NACLD were reported 12 or more months before pancreatic cancer diagnosis or control selection using Medicare claims data. Adjusted unconditional logistic regression models were used to calculate ORs and 95% confidence intervals (CI) between hemochromatosis, sideroblastic and congenital dyserythropoietic anemias, NACLD, and pancreatic cancer. Results: Between 1992 and 2015, 80,074 pancreatic cancer cases and 320,296 controls were identified. Overall, we did not observe statistically significant associations between hemochromatosis, sideroblastic anemia, or congenital dyserythropoietic anemia and pancreatic cancer; however, sideroblastic anemia was associated with later primary pancreatic cancer (OR, 1.30; 95% CI, 1.03–1.64). NACLD was associated with first (OR, 1.10; 95% CI, 1.01–1.19), later (OR, 1.17; 95% CI, 1.02–1.35), and all (OR, 1.12; 95% CI, 1.04–1.20) pancreatic cancer. Conclusions: Overall hemochromatosis and iron-overload anemias were not associated with pancreatic cancer, whereas NACLD was associated with increased risk in this large study of older adults. Impact: These results partly support the hypothesis that iron-overload diseases increase pancreatic cancer risk.

中文翻译：

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监测、流行病学和最终结果 (SEER) 中的血色病、铁过载相关疾病和胰腺癌风险 - 医疗保险

背景：实验研究表明，铁过载可能会增加胰腺癌的风险。我们评估了诊断前的血色病和铁过载疾病，包括铁粒幼细胞性和先天性红细胞生成障碍性贫血，以及非酒精性慢性肝病 (NACLD) 是否与老年人的胰腺癌风险相关。方法：我们在美国监测、流行病学和最终结果计划 (SEER)-医疗保险关联数据中进行了一项基于人群的病例对照研究。事件原发性胰腺癌病例是成年人 > 66 岁。对照在确诊病例并按年龄、性别和日历年与病例匹配（4:1 的比例）时还活着。血色病、铁过载性贫血、和 NACLD 是在胰腺癌诊断或对照选择前 12 个月或更长时间使用医疗保险索赔数据报告的。使用调整后的非条件逻辑回归模型计算血色病、铁粒幼细胞和先天性红细胞生成障碍性贫血、NACLD 和胰腺癌之间的 OR 和 95% 置信区间 (CI)。结果：1992 年至 2015 年间，共鉴定出 80,074 例胰腺癌病例和 320,296 例对照。总体而言，我们没有观察到血色病、铁粒幼细胞性贫血或先天性红细胞生成障碍性贫血与胰腺癌之间存在统计学上的显着关联；然而，铁粒幼细胞性贫血与后来的原发性胰腺癌有关（OR，1.30；95% CI，1.03-1.64）。NACLD 与第一个 (OR, 1.10; 95% CI, 1.01–1.19), 后来 (OR, 1.17; 95% CI, 1.02–1.35) 和所有 (OR, 1.12; 95% CI, 1.04–1.20) 胰腺癌。结论：在这项针对老年人的大型研究中，总体血色病和铁过载性贫血与胰腺癌无关，而 NACLD 与风险增加有关。影响：这些结果部分支持铁过载疾病会增加胰腺癌风险的假设。