Journal of the National Cancer Institute Advance Access originally published online on March 10, 2009
JNCI Journal of the National Cancer Institute 2009 101(6):424-431; doi:10.1093/jnci/djp020
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© The Author 2009. Published by Oxford University Press.
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ABO Blood Group and the Risk of Pancreatic Cancer
Affiliations of authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA (BMW, CSF); Channing Laboratory (ATC, ELG, CSF), Department of Medicine (BMW, DJH, CSF), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA (ATC); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (PH, SJC); Department of Epidemiology (PK, DJH, ELG) and Department of Nutrition (DJH, ELG), Harvard School of Public Health, Boston, MA
Correspondence to: Brian M. Wolpin, MD, Department of Medical Oncology, Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115 (e-mail: bwolpin{at}partners.org).
Background: Other than several rare, highly penetrant familial syndromes, genetic risk factors for sporadic pancreatic cancer are largely unknown. ABO blood type is an inherited characteristic that in previous small studies has been associated with the risk of gastrointestinal malignancies.
Methods: We separately examined the relationship between ABO blood type and the risk of incident pancreatic cancer in two large, independent, prospective cohort studies (the Nurses’ Health Study and Health Professionals Follow-up Study) that collected blood group data on 107 503 US health professionals. Hazard ratios for pancreatic cancer by ABO blood type were calculated using Cox proportional hazards models with adjustment for other known risk factors, including age, tobacco use, body mass index, physical activity, and history of diabetes mellitus. All statistical tests were two-sided.
Results: During 927 995 person-years of follow-up, 316 participants developed pancreatic cancer. ABO blood type was associated with the risk of developing pancreatic cancer (P = .004; log-rank test). Compared with participants with blood group O, those with blood groups A, AB, or B were more likely to develop pancreatic cancer (adjusted hazard ratios for incident pancreatic cancer were 1.32 [95% confidence interval {CI} = 1.02 to 1.72], 1.51 [95% CI = 1.02 to 2.23], and 1.72 [95% CI = 1.25 to 2.38], respectively). The association between blood type and pancreatic cancer risk was nearly identical in the two cohorts (Pinteraction = .97). Overall, 17% of the pancreatic cancer cases were attributable to inheriting a non-O blood group (blood group A, B, or AB). The age-adjusted incidence rates for pancreatic cancer per 100 000 person-years were 27 (95% CI = 23 to 33) for participants with blood type O, 36 (95% CI = 26 to 50) for those with blood type A, 41 (95% CI = 31 to 56) for those with blood type AB, and 46 (95% CI = 32 to 68) for those with blood type B.
Conclusions: In two large, independent populations, ABO blood type was statistically significantly associated with the risk of pancreatic cancer. Further studies are necessary to define the mechanisms by which ABO blood type or closely linked genetic variants may influence pancreatic cancer risk.
| CONTEXT AND CAVEATS Prior knowledge The genetic determinants of sporadic pancreatic cancer were unknown. Previous studies had suggested that blood type (A, B, AB, or O) might be associated with various malignancies, including pancreatic cancer. Study design The association of blood type and risk of pancreatic cancer was studied in the context of two prospective cohort studies. Cox proportional hazards models were used to calculate the risk of pancreatic cancer by blood type after adjustment for other known risk factors. Contributions This study found that there was a slightly increased risk of pancreatic cancer in those with blood groups A, AB, or B relative to those with blood group O, such that approximately 17% of pancreatic cancers were attributable to a non-O blood group. Implications Additional studies will be necessary to determine the biological basis for the association of blood group and pancreatic cancer risk. Limitations This study could not determine whether the ABO gene itself or genetic variations closely linked to this gene are the basis of the observed associations. From the Editors
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Manuscript received July 15, 2008; revised December 11, 2008; accepted January 16, 2009.
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J Natl Cancer Inst 2009 101: 361.
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  M. Saadat Re: ABO Blood Group and the Risk of Pancreatic Cancer J Natl Cancer Inst, September 16, 2009; 101(18): 1285 - 1286. [Full Text] [PDF]
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P. Maisonneuve, S. Iodice, J-M. Lohr, and A. B. Lowenfels Re: ABO Blood Group and the Risk of Pancreatic Cancer J Natl Cancer Inst, August 19, 2009; 101(16): 1156 - 1156. [Full Text] [PDF]
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