An equally dismal picture occurs with cancer of the pancreas, for which the 5-year survival rate is only 2%. Because of the nonspecific nature of the initial symptoms and the difficulty in making a diagnosis, the mean survival time after diagnosis of pancreatic cancer is less than 6 months. Smokers have two to three times the risk of pancreatic cancer as nonsmokers, and the risk is proportional to the amount smoked. Increased risk persists at least 10 years after quitting. More than one fourth of pancreatic cancer cases (27%) are attributable to cigarette smoking (Silverman et al., 1994; US Surgeon General, 2004).

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