Rachael Stolzenberg-Solomon

Ph.D., MPH, RD

NCI, DCEG, MEB

Senior Investigator

PLCO (Learn more about this study)

2012-0035

Apr 27, 2012

Serum trace and ultra-trace metals and pancreatic cancer

Pancreatic adenocarcinoma is among the most fatal cancers worldwideand one for which few established preventable risk factors. Limited studies have evaluated trace elements and risk of pancreatic cancer. Two recent studies have examined trace metals and pancreatic cancer. A Spanish case control study (118 cases and 399 controls) examined the association between 12 trace elements in participants' toenails and demonstrated significant elevated risks for participants with high concentrations of cadmium (Cd, OR=3.58, 95% CI 1.86-6.99, p-trend=5x10^-6), arsenic (As, OR=2.2, 95% CI 1.08-3.78, p-trend=0.009), and lead (Pb, OR=6.26, 95% CI 2.71-14.47, p-trend=3x10^-5). The second study showed a significant 7-fold risk between urinary As and pancreatic cancer in men (n=23 cases) in NHANES III. Both studies are limited by the relatively small number of pancreatic cancer cases. The Spanish study's limitations included potential selection bias of both cases and controls, reverse causation and in ability to establish a temporal relationship. These studies need replication particularly in a prospective study. We propose to conduct a nested case-control (300-350 cases, 600-700 matched controls) study within the PLCO Trial using T0 serum to examine whether trace elements are prospectively associated with pancreatic cancer. We hypothesize that trace elements will be associated with pancreatic cancer. The PLCO Trial cohort provides a unique opportunity to test this hypothesis as a proportion of serum was collected at baseline in a manner that prevented contamination with exogenous sources of metals (i.e. royal blue top tubes). Serum concentrations of trace (i.e. Cu, Zn, Fe, Mg) and ultra trace (i.e. Cd, Pb, As, Cr) elements will be measured in the laboratory of Dr. John Brockman whose laboratory measures trace and ultra-trace elements using isotope dilution inductively coupled plasma mass spectrometry (ICP-MS) reliably and with precision. The results from this study will provide new insight into exposures that may be related to pancreatic carcinogenesis and have important implications for the prevention of pancreatic cancer.