J Gastrointest Canc (2015) 46:126–130 DOI 10.1007/s12029-015-9693-4
ORIGINAL RESEARCH
Epidemiology and Risk Factors for Exocrine Pancreatic Cancer in a Northern African Population Feriel Sellam & Noria Harir & Méghit B. Khaled & Nesrine M. Mrabent & Rachida Salah & Mustapha Diaf
Published online: 4 March 2015 # Springer Science+Business Media New York 2015
Abstract Background The etiology of pancreatic cancer remains largely unknown. Although epidemiological studies have reported that many environmental factors may contribute to the development of pancreatic cancer, only age and cigarette smoking have been established as consistent risk factors for the disease. Objective Studying the biological clinical and histological features of patients with pancreatic cancer in order to assess the possible risk factors for pancreatic cancer in a North African population. Methods An epidemiological retrospective descriptive study has been performed at the level of surgery department of the university hospital of Sidi bel Abbes region, western Algeria, from 2007 to 2013.
F. Sellam (*) : N. Harir : M. B. Khaled : N. M. Mrabent : R. Salah : M. Diaf
Results A total of 87 patients were diagnosed with cancer of the pancreas (55 males and 32 females) with a mean age of 63.1 years, ranging from 16 to 96 years old, and a sex ratio of 1.71. In 92 % of cases, pancreatic tumors were located at the head of the pancreas; the most predominant histological type was the adenocarcinoma; cigarette smokers represented the rate of 24.3 % and alcoholics 13.5 %. The most recorded disease among patients medical history was diabetes mellitus (25.28 %). About 35.63 % was the prominent rate of patients who underwent cholecystectomy and was diagnosed with pancreatic cancer after an average duration of 5.23 years. Our patients were mostly diagnosed with cancer at M1 and T3 stages. Conclusion According to our results, cholecystectomy could possibly be a risk factor for pancreatic cancer in Algerian population Keywords Pancreatic cancer . Epidemiology . Risk factors . Northern African population
Department of Biology, Djillali Liabes University, Sidi bel Abbes, Algeria e-mail:
[email protected] N. Harir e-mail:
[email protected]
Introduction
M. B. Khaled e-mail:
[email protected]
Pancreatic cancer is one of the deadliest cancers with a 5-year survival rate of less than 5 % and is the fourth largest cause of cancer-related deaths in the USA [1]. While overall cancer incidence and death rates are declining, the incidence and death rates for pancreatic cancer have been increasing. The number of new pancreatic cancer cases in the USA has been projected to increase by 55 % between 2010 and 2030 [2]. The etiology of pancreatic cancer remains largely unknown. Although epidemiological studies have reported that many environmental factors may contribute to the
N. M. Mrabent e-mail:
[email protected] R. Salah e-mail:
[email protected] M. Diaf e-mail:
[email protected] N. Harir Department Laboratory of molecular microbiology, Djillali Liabes University, Sidi bel Abbes, Algeria
J Gastrointest Canc (2015) 46:126–130
development of pancreatic cancer, only age and cigarette smoking have been established as consistent risk factors for the disease [3]. Cholecystectomy has been found to increase serum levels of cholecystokinin (CCK) [4]. CCK has been shown to stimulate both gallbladder contraction and pancreatic enzyme secretion [5] and to have atrophic effect on pancreatic acinar cells [6]. The trophic effect on the pancreas by the presumed increased release of cholecystokinin following cholecystectomy and a perturbation of the neurohormonal pancreatic regulation has been suggested as possible contributing factors for pancreatic cancer [7, 8]. Our purpose through the current scientific investigation is to study the biological clinical and histological features of patients with pancreatic cancer in order to assess the possible risk factors for pancreatic cancer in a North African population. To that end, we performed an epidemiological retrospective study to analyse the records of patients with pancreatic cancer at the region of Sidi bel Abbes, western Algeria from 2007 to 2013.
Patients and Methods Our retrospective study was performed using a database with 87 patients with pancreatic cancer who had been diagnosed at the pathology and surgery departments of the University Hospital Center of Sidi bel Abbes, from 2007 to 2013. The clinical records of the patients were reviewed for medical history, surgical history, smoking and alcohol history, symptoms and signs, histopathology, and the clinical staging of pancreatic cancer. Only patients with a confirmed pathological cell type and adequate medical records were included for the analysis. Statistical Analyses Concerning the statistical analytical study, the data were summarized using rates and cross-tabulations. Associations between categorical parameters were tested using Pearson’s chi-squared test (χ2) and Cramér’s phi (φc) test. Results were presented using p value, the level of its significance was limited by the rate of 5 %. All data were processed and analyzed via SPSS 20.0 (Statistical Package for the Social Sciences, IBM Corporation; Chicago, IL. August 2011).
Results Our survey has been done over 87 patients (63 % males and 37 % females). We reported an overall male predominance with the male to female ratio of 1.71, the mean age was about 63.1 years, ranging from 16 to 96 years old. The most affected age group by pancreatic cancer was the 61–80 years old with a
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rate of 57.4 %, followed respectively by the ranges of 41– 60 years old (25.2 %), 81–100 years (11.5 %), 21–40 years (4.6 %), and the least affected age range was the 01–20 years (1.14 %) (Table 1). While no female smokers were reported in our investigation, 24.3 % male patients were cigarette smokers at and 13.5 % were alcoholics (Table 1).
Table 1
Patients medical features
Characteristics
Sex (n=87) Male Female Sex ratio Age (>20) (21–40) (41–60) (61–80) (
