The investigator propose a population-based, case-control study in men
and women to examine hypotheses linking adenocarcinoma of the exocrine
pancreas and detailed occupational history and chemical exposures (in
particular chlorinated hydrocarbons and aromatic amines), diet, cigarette
smoking, allergies, and other factors. A molecular genetic study of
polymorphisms at the CYP2D6 gene locus will be conducted to investigate
the possible role of genetic risk factors in the metabolism of cigarette-
derived chemical carcinogens in pancreatic cancer risk. The study will
include all patients with adenocarcinoma of the exocrine pancreas who are
between the ages of 21 and 85, who speak English or Spanish, and who live
in the six-county San Francisco Bay Area at time of diagnosis. 1000 cases
and 1150 controls will be interviewed during the 3.5 year case-
ascertainment period. Ongoing rapid case ascertainment methods, using
hospital discharge lists and pathology laboratories, will be employed to
locate pancreatic cancer patients in the study area within two weeks of
diagnosis. Pathology slides for patients will be reviewed by a senior
pathologist at the University of California San Francisco (UCSF).
Controls will be identified using random digit dial and will be frequency
matched to cases by sex and 5-year age group. Two controls for each black
and Hispanic patient will be obtained to achieve adequate statistical
power and one control will be obtained for each of the other patients.
Controls over age 65 years will be randomly selected from the rolls of
the Health Care Financing Administration in addition to those chosen from
the general population. Structured personal interviews will be conducted
by trained interviewers in study subjects' homes or at a place convenient
to the subject. Interview topics will include: detailed information on
occupations and chemical and industrial exposures, diet, medical and
allergy history, medication use, family history or pancreatic cancer and
other relevant conditions, demographic and other factors. Blood samples
for genetic investigation will be drawn by phlebotomists in the subjects'
homes. Serum will be stored in aliquots at -40 degrees and cell samples
will be stored frozen with liquid nitrogen in the Irwin Memorial Blood
Bank. Whole blood specimens also will be stored for future genetic and
biomarker studies. Analyses will be conducted using univariate and
multivariate statistics with careful attention paid to potential
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