Phenotypic CYP2A6 variation and the risk of pancreatic cancer

Susan Kadlubar, Jeffrey P. Anderson, Carol Sweeney, Myron D. Gross, Nicholas P. Lang, Fred F. Kadlubar, Kristin E. Anderson

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Objective: Cytochrome P450 2A6 (CYP2A6) is an important metabolic enzyme capable of activating several procarcinogens, including dietary and tobacco-specific nitrosamines, which have been linked to pancreatic cancer. Positive associations between high CYP2A6 activity and lung and colorectal cancers have been reported. This is the first investigation of CYP2A6 activity and pancreatic cancer. Design: In this case-control study of cancer of the exocrine pancreas, phenotypic CYP2A6 activity was measured using a ratio of urinary caffeine metabolites. Demographic, smoking, dietary and medical information were obtained by questionnaire. CYP2A6 phenotype, which is not influenced by smoking status, was measured for 90 cases and 470 controls. Results: When modeled as a continuous variable, and adjusted for age, sex, race, education, current smoking status and chronic pancreatitis, the odds ratio (OR) per one unit of the natural log of the CYP2A6 ratio was 1.52 (95% confidence interval, CI: 1.09-2.12). In an adjusted categorical analysis, subjects in the uppermost quartile (based on controls) of CYP2A6 activity, when compared to the lower three quartiles, carried an 80% greater risk of pancreatic cancer (OR=1.80; 95% CI: 1.07-3.02). Conclusions: High levels of CYP2A6 activity, as measured by a caffeine phenotyping assay, were positively associated with pancreatic cancer in this case-control study among a Midwestern U.S. population.

Original languageEnglish (US)
Pages (from-to)263-270
Number of pages8
JournalJournal of the Pancreas
Issue number3
StatePublished - 2009


  • Coumarin 7-hydroxylase
  • Nitrosamines
  • Pancreatic neoplasms
  • Risk


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