The primary model adjusted for age at enrollment, body mass index, smoking status, type 2 diabetes, and Townsend deprivation index. Follow-up began at the 5-year landmark and continued until incident registry-confirmed PDAC, death, or administrative censoring. The sensitivity analysis included 91,745 matched participants in each exposure group and used Cox proportional hazards regression stratified by matched pair. HR: hazard ratio; HRT: hormone replacement therapy; PDAC: pancreatic ductal adenocarcinoma.
Declarations
Author contributions
SL: Conceptualization, Methodology, Formal analysis, Data curation, Investigation, Visualization, Writing—original draft, Writing—review & editing. PHR: Conceptualization, Methodology, Data curation, Writing—review & editing. All authors read and approved the final manuscript and agree to be accountable for all aspects of the work.
Conflicts of interest
The authors declare that they have no competing interests.
Ethical approval
This study analyzed de-identified, publicly available secondary data and did not involve interaction with human participants or access to identifiable private information. The use of SEER Research Data is governed by the National Cancer Institute Data-Use Agreement, and FAERS data accessed via OpenVigil are publicly available and fully anonymized. In accordance with U.S. federal regulations (45 CFR 46) and institutional policies, this study was determined to be exempt from Institutional Review Board (IRB) review, and informed consent was not required. The study was conducted in accordance with the Declaration of Helsinki.
Consent to participate
Not required.
Consent to publication
Not required.
Availability of data and materials
The data analyzed in this study are derived from publicly accessible resources. Cancer incidence data were obtained from the Surveillance, Epidemiology, and End Results (SEER) Research Data program (SEER Research Plus Data, 8 Registries, November 2024 submission; diagnoses 1975–2022), available to qualified investigators through the National Cancer Institute upon execution of a SEER Research Data Agreement. Pharmacovigilance analyses were conducted using OpenVigil 2.1, which provides curated access to the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database. UK Biobank analyses were conducted under approved application access (application number 57245). UK Biobank data are available to bona fide researchers for health-related research in the public interest upon project approval through the UK Biobank Research Analysis Platform (https://www.ukbiobank.ac.uk/enable-your-research/apply-for-access). Derived variables and analytical code from this study are available from the corresponding author upon reasonable request, subject to compliance with UK Biobank data sharing policies. All analyses were performed on de-identified, aggregated data. No individual-level participant data are publicly shared by the authors.
Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.
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