{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T11:45:16Z","timestamp":1782733516443,"version":"3.54.5"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Vitamin D deficiency (VDD) is highly prevalent worldwide; however, its association with pancreatic cancer risk remains inconclusive, and prior evidence has included a substantial proportion of case\u2013control studies. This retrospective cohort study used the TriNetX Global Collaborative Network to identify adults (age \u2265 40 years) with at least two serum 25-hydroxyvitamin D measurements between 2010 and 2023. The VDD (&lt;20\u2009ng\/ml) and control (\u226530\u2009ng\/ml) cohorts were matched in a 1:1 ratio using propensity scores. A 2-year landmark period was applied. The primary outcome was incident pancreatic cancer within 10 years. Secondary outcomes included acute and chronic pancreatitis. After matching, 316 681 patients remained in each cohort. VDD was associated with a higher risk of pancreatic cancer (hazard ratio: 1.53, 95% confidence interval: 1.30\u20131.80,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005&lt;\u20050.001), acute pancreatitis (hazard ratio: 2.03,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005&lt;\u20050.001), and chronic pancreatitis (hazard ratio: 2.28,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005&lt;\u20050.001). The negative control outcome (appendicitis) showed no significant difference (hazard ratio: 1.04,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005=\u20050.252), whereas healthcare visits used to assess detection bias were lower in the VDD group (hazard ratio: 0.88,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005&lt;\u20050.001). Results remained consistent across all sensitivity models. No significant interaction was observed according to sex or age. Severe VDD (&lt;10\u2009ng\/ml) demonstrated a stronger association with pancreatic cancer (hazard ratio: 2.25,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005&lt;\u20050.001), supporting an exposure\u2013gradient pattern. VDD was associated with higher subsequent risks of pancreatic cancer and pancreatitis, with stronger associations at lower vitamin D levels. These observational findings require prospective confirmation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/cej.0000000000001027","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T14:01:42Z","timestamp":1781791302000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Risk of pancreatic cancer in patients with vitamin D deficiency: a retrospective cohort study"],"prefix":"10.1097","author":[{"given":"Yi-Chen","family":"Lai","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Chi Mei Hospital, Tainan City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Chen","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo-Chuan","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Chi Mei Hospital, Tainan City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Wei","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Chi Mei Hospital, Tainan City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Wen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Chi Mei Hospital, Liouying, Tainan City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"R1-20260629","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.3390\/biom11111624","article-title":"The effects of vitamin D on immune system and inflammatory 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