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Lennart Domellof

Bio: Lennart Domellof is an academic researcher from Örebro University. The author has contributed to research in topics: Pancreatitis & Risk factor. The author has an hindex of 4, co-authored 5 publications receiving 1976 citations.

Papers
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Journal ArticleDOI
TL;DR: A multicenter historical cohort study of 2015 subjects with chronic pancreatitis who were recruited from clinical centers in six countries finds that pancreatitis may be a risk factor for pancreatic cancer, but the magnitude of the relation between these two diseases is unclear.
Abstract: Background The results of case-control studies and anecdotal reports suggest that pancreatitis may be a risk factor for pancreatic cancer, but there have been no studies of sufficient size and power to assess the magnitude of the relation between these two diseases. Methods and Results We undertook a multicenter historical cohort study of 2015 subjects with chronic pancreatitis who were recruited from clinical centers in six countries. A total of 56 cancers were identified among these patients during a mean (±SD) follow-up of 7.4 ±6.2 years. The expected number of cases of cancer calculated from country-specific incidence data and adjusted for age and sex was 2.13, yielding a standardized incidence ratio (the ratio of observed to expected cases) of 26.3 (95 percent confidence interval, 19.9 to 34.2). For subjects with a minimum of two or five years of follow-up, the respective standardized incidence ratios were 16.5 (95 percent confidence interval, 11.1 to 23.7) and 14.4 (95 percent confidence interval, 8...

1,528 citations

Journal ArticleDOI
01 Apr 2005-Gut
TL;DR: In this study, tobacco smoking was associated with earlier diagnosis of chronic alcoholic pancreatitis and with the appearance of calcifications and diabetes, independent of alcohol consumption.
Abstract: Background: Smoking is a recognised risk factor for pancreatic cancer and has been associated with chronic pancreatitis and also with type II diabetes. Aims: The aim of this study was to investigate the effect of tobacco on the age of diagnosis of pancreatitis and progression of disease, as measured by the appearance of calcification and diabetes. Patients: We used data from a retrospective cohort of 934 patients with chronic alcoholic pancreatitis where information on smoking was available, who were diagnosed and followed in clinical centres in five countries. Methods: We compared age at diagnosis of pancreatitis in smokers versus non-smokers, and used the Cox proportional hazards model to evaluate the effects of tobacco on the development of calcification and diabetes, after adjustment for age, sex, centre, and alcohol consumption. Results: The diagnosis of pancreatitis was made, on average, 4.7 years earlier in smokers than in non-smokers (p = 0.001). Tobacco smoking increased significantly the risk of pancreatic calcifications (hazard ratio (HR) 4.9 (95% confidence interval (CI) 2.3–10.5) for smokers v non-smokers) and to a lesser extent the risk of diabetes (HR 2.3 (95% CI 1.2–4.2)) during the course of pancreatitis. Conclusions: In this study, tobacco smoking was associated with earlier diagnosis of chronic alcoholic pancreatitis and with the appearance of calcifications and diabetes, independent of alcohol consumption.

301 citations

Journal ArticleDOI
TL;DR: Age at diagnosis, smoking, and drinking are major predictors of mortality in patients with chronic pancreatitis, and those with alcoholic pancreatitis had a significant reduction in survival.

187 citations

Journal ArticleDOI
TL;DR: It seems likely that gallstone disease and several common cancers in younger Swedish women share similar epidemiologic and perhaps metabolic features.

57 citations

Book ChapterDOI
01 Jan 1994
TL;DR: It is suggested that reduced consumption of certain dietary items, such as consumption of fresh fruits and vegetables, may lead to the formation of pancreatic cancers, as they do against other tumors.
Abstract: Little is known about the cause (or causes) of pancreatic cancer, a lethal gastrointestinal cancer that represents a diagnostic and therapeutic challenge for physicians. There is nearly universal agreement that smoking increases the risk of pancreatic cancer [1–4], but the approximately tow-fold increased risk is much less that the risk of lung cancer in smokers. Alcohol, a well established risk factor for chronic pancreatitis, does not seem to be associated with pancreatic cancer [5]. A few cases of pancreatic cancer can be linked to industrial exposures to agents such as DDT [6]. Reduced consumption of certain dietary items, such as consumption of fresh fruits and vegetables may lead to the formation of pancreatic cancers, as they do against other tumors [7]. However, these known causes explain less than half of all known cases pancreatic cancer, suggesting that there are other causes which remain undetected.

Cited by
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Journal ArticleDOI
TL;DR: Observations to date suggest that oxidative stress, chronic inflammation, and cancer are closely linked.

3,922 citations

Journal ArticleDOI
Geou Yarh Liou1, Peter Storz1
TL;DR: The generation of ROS within tumour cells, their detoxification, their cellular effects, as well as the major signalling cascades they utilize are discussed, but also an outlook on their modulation in therapeutics is provided.
Abstract: Elevated rates of reactive oxygen species (ROS) have been detected in almost all cancers, where they promote many aspects of tumour development and progression. However, tumour cells also express increased levels of antioxidant proteins to detoxify from ROS, suggesting that a delicate balance of intracellular ROS levels is required for cancer cell function. Further, the radical generated, the location of its generation, as well as the local concentration is important for the cellular functions of ROS in cancer. A challenge for novel therapeutic strategies will be the fine tuning of intracellular ROS signalling to effectively deprive cells from ROS-induced tumour promoting events, towards tipping the balance to ROS-induced apoptotic signalling. Alternatively, therapeutic antioxidants may prevent early events in tumour development, where ROS are important. However, to effectively target cancer cells specific ROS-sensing signalling pathways that mediate the diverse stress-regulated cellular functions need to be identified. This review discusses the generation of ROS within tumour cells, their detoxification, their cellular effects, as well as the major signalling cascades they utilize, but also provides an outlook on their modulation in therapeutics.

2,625 citations

Journal ArticleDOI
TL;DR: Up-to-date statistics on pancreatic cancer occurrence and outcome along with a better understanding of the etiology and identifying the causative risk factors are essential for the primary prevention of this disease.
Abstract: Pancreatic cancer is the seventh leading cause of cancer-related deaths worldwide. However, its toll is higher in more developed countries. Reasons for vast differences in mortality rates of pancreatic cancer are not completely clear yet, but it may be due to lack of appropriate diagnosis, treatment and cataloging of cancer cases. Because patients seldom exhibit symptoms until an advanced stage of the disease, pancreatic cancer remains one of the most lethal malignant neoplasms that caused 432,242 new deaths in 2018 (GLOBOCAN 2018 estimates). Globally, 458,918 new cases of pancreatic cancer have been reported in 2018, and 355,317 new cases are estimated to occur until 2040. Despite advancements in the detection and management of pancreatic cancer, the 5-year survival rate still stands at 9% only. To date, the causes of pancreatic carcinoma are still insufficiently known, although certain risk factors have been identified, such as tobacco smoking, diabetes mellitus, obesity, dietary factors, alcohol abuse, age, ethnicity, family history and genetic factors, Helicobacter pylori infection, non-O blood group and chronic pancreatitis. In general population, screening of large groups is not considered useful to detect the disease at its early stage, although newer techniques and the screening of tightly targeted groups (especially of those with family history), are being evaluated. Primary prevention is considered of utmost importance. Up-to-date statistics on pancreatic cancer occurrence and outcome along with a better understanding of the etiology and identifying the causative risk factors are essential for the primary prevention of this disease.

1,278 citations

Journal ArticleDOI
TL;DR: It is concluded that an adequate pancreatic biopsy must be the gold standard against which all diagnostic approaches are judged and the roles of endoscopic retrograde pancreatography, endoscopic ultrasonography, and magnetic resonance imaging are considered.

1,131 citations