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 confounders.
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