In 2020, 146,063 deaths due to pancreatic cancer are estimated to occur in Europe and the United States combined. To identify common susceptibility alleles, we performed the largest pancreatic cancer GWAS to date, including 9040 patients and 12,496 controls of European ancestry from the Pancreatic Cancer Cohort Consortium (PanScan) and the Pancreatic Cancer Case-Control Consortium (PanC4). Here, we find significant evidence of a novel association at rs78417682 (7p12/TNS3, P = 4.35 × 10-8). Replication of 10 promising signals in up to 2737 patients and 4752 controls from the PANcreatic Disease ReseArch (PANDoRA) consortium yields new genome-wide significant loci: rs13303010 at 1p36.33 (NOC2L, P = 8.36 × 10-14), rs2941471 at 8q21.11 (HNF4G, P = 6.60 × 10-10), rs4795218 at 17q12 (HNF1B, P = 1.32 × 10-8), and rs1517037 at 18q21.32 (GRP, P = 3.28 × 10-8). rs78417682 is not statistically significantly associated with pancreatic cancer in PANDoRA. Expression quantitative trait locus analysis in three independent pancreatic data sets provides molecular support of NOC2L as a pancreatic cancer susceptibility gene.

1st Department of Medicine University of Szeged 6725 Szeged Hungary

ARC NET Centre for Applied Research on Cancer University and Hospital Trust of Verona 37134 Verona Italy

Boston VA Healthcare System Boston MA 02132 USA

Cancer Care Ontario University of Toronto Toronto Ontario M5G 2L7 Canada

Cancer Epidemiology and Intelligence Division Cancer Council Victoria Melbourne VIC 3004 Australia

Cancer Epidemiology Program University of Hawaii Cancer Center Honolulu HI 96813 USA

Cancer Genomics Research Laboratory National Cancer Institute Division of Cancer Epidemiology and Genetics Leidos Biomedical Research Inc Frederick National Laboratory for Cancer Research Frederick MD 21702 USA

Centre de Recherche en Épidémiologie et Santé des Populations Facultés de Medicine Université Paris Saclay UPS UVSQ Gustave Roussy 94800 Villejuif France

Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health The University of Melbourne Parkville VIC 3010 Australia

CIBER Epidemiología y Salud Pública 08003 Barcelona Spain

CIBERONC 28029 Madrid Spain

Dalla Lana School of Public Health University of Toronto Toronto Ontario M5T 3M7 Canada

Departament de Ciències Experimentals i de la Salut Universitat Pompeu Fabra 08002 Barcelona Spain

Department for Determinants of Chronic Diseases 3720 BA Bilthoven The Netherlands

Department of Basic Medical Sciences Laboratory of Biology Medical School National and Kapodistrian University of Athens 106 79 Athens Greece

Department of Biology University of Pisa 56126 Pisa Italy

Department of Biostatistics Harvard School of Public Health Boston MA 02115 USA

Department of Cancer Epidemiology and Genetics Masaryk Memorial Cancer Institute 65653 Brno Czech Republic

Department of Chronic Disease Epidemiology Yale School of Public Health New Haven CT 06520 USA

Department of Computational Biology St Jude Children's Research Hospital Memphis TN 38105 USA

Department of Digestive Tract Diseases Medical University of Łodz 90 647 Łodz Poland

Department of Environmental Medicine New York University School of Medicine New York NY 10016 USA

Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center New York NY 10065 USA

Department of Epidemiology and Biostatistics School of Public Health Imperial College London London SW7 2AZ UK

Department of Epidemiology and Biostatistics University of California San Francisco San Francisco CA 94158 USA

Department of Epidemiology and Environmental Health University at Buffalo Buffalo NY 14214 USA

Department of Epidemiology and Preventive Medicine Monash University Melbourne VIC 3004 Australia

Department of Epidemiology and Public Health Faculty of Medicine University of Ostrava 701 03 Ostrava Czech Republic

Department of Epidemiology Harvard School of Public Health Boston MA 02115 USA

Department of Epidemiology Harvard T H Chan School of Public Health Boston MA 02115 USA

Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD 21205 USA

Department of Epidemiology University of Texas MD Anderson Cancer Center Houston TX 77230 USA

Department of Epidemiology University of Washington Seattle WA 98195 USA

Department of Gastroenterology and Hepatology University Medical Centre 3584 CX Utrecht The Netherlands

Department of Gastroenterology Lithuanian University of Health Sciences 44307 Kaunas Lithuania

Department of Gastrointestinal Medical Oncology University of Texas MD Anderson Cancer Center Houston TX 77030 USA

Department of General Surgery University Hospital Heidelberg 69120 Heidelberg Germany

Department of General Surgery University of Heidelburg Heidelberg Germany

Department of General Visceral and Thoracic Surgery University Hamburg Eppendorf 20246 Hamburg Germany

Department of Health Sciences Research Mayo Clinic College of Medicine Rochester MN 55905 USA

Department of Hematology Institute of Hematology and Transfusion Medicine 02 776 Warsaw Poland

Department of Medical Oncology Dana Farber Cancer Institute Boston MA 02215 USA

Department of Medicine Georgetown University Washington 20057 USA

Department of Medicine Memorial Sloan Kettering Cancer Center New York NY 10065 USA

Department of Molecular Biology of Cancer Institute of Experimental Medicine Academy of Sciences of the Czech Republic 142 20 Prague 4 Czech Republic

Department of Obstetrics and Gynecology New York University School of Medicine New York NY 10016 USA

Department of Oncology Faculty of Medicine and Dentistry Palacky University Olomouc and University Hospital 775 20 Olomouc Czech Republic

Department of Oncology Sidney Kimmel Comprehensive Cancer Center Johns Hopkins School of Medicine Baltimore MD 21231 USA

Department of Pathology Academic Medical Center University of Amsterdam 1007 MB Amsterdam The Netherlands

Department of Pathology Sol Goldman Pancreatic Cancer Research Center Johns Hopkins School of Medicine Baltimore MD 21287 USA

Department of Population Health New York University School of Medicine New York NY 10016 USA

Department of Preventive Medicine Keck School of Medicine University of Southern California Los Angeles CA 90032 USA

Department of Public Health Solutions National Institute for Health and Welfare 00271 Helsinki Finland

Department of Radiation Oncology Sidney Kimmel Comprehensive Cancer Center Johns Hopkins School of Medicine Baltimore MD 21231 USA

Department of Social and Preventive Medicine Faculty of Medicine University of Malaya 50603 Kuala Lumpur Malaysia

Department of Surgery Oncology and Gastroenterology University of Padua 35124 Padua Italy

Department of Surgical and Perioperative Sciences Umeå University 901 85 Umeå Sweden

Department of Translational Research and The New Technologies in Medicine and Surgery University of Pisa 56126 Pisa Italy

Digestive and Liver Disease Unit 'Sapienza' University of Rome 00185 Rome Italy

Division of Aging Brigham and Women's Hospital Boston MA 02115 USA

Division of Cancer Control and Population Sciences National Cancer Institute National Institutes of Health Bethesda MD 20892 USA

Division of Cancer Epidemiology and Genetics National Cancer Institute National Institutes of Health Bethesda MD 20892 USA

Division of Cancer Epidemiology German Cancer Research Center 69120 Heidelberg Germany

Division of Clinical Epidemiology and Aging Research German Cancer Research Center 69120 Heidelberg Germany

Division of Epidemiology Department of Medicine Vanderbilt Epidemiology Center Vanderbilt Ingram Cancer Center Vanderbilt University School of Medicine Nashville TN 37232 USA

Division of Gastroenterology and Research Laboratory IRCCS Scientific Institute and Regional General Hospital Casa Sollievo della Sofferenza 71013 San Giovanni Rotondo FG Italy

Division of Preventive Medicine Brigham and Women's Hospital Boston MA 02215 USA

Division of Preventive Oncology German Cancer Research Center 69120 Heidelberg Germany

Division of Public Health Sciences Fred Hutchinson Cancer Research Center Seattle WA 98109 USA

Division of Research Kaiser Permanente Northern California Oakland CA 94612 USA

Epidemiology Research Program American Cancer Society Atlanta GA 30303 USA

Epithelial Carcinogenesis Group Spanish National Cancer Research Centre CNIO 28029 Madrid Spain

Faculty of Medicine University of Olomouc 771 47 Olomouc Czech Republic

Gastroenterology and Gastrointestinal Endoscopy Unit Vita Salute San Raffaele University IRCCS San Raffaele Scientific Institute 20132 Milan Italy

Genetic and Molecular Epidemiology Group Spanish National Cancer Research Center 28029 Madrid Spain

Genomic Epidemiology Group German Cancer Research Center 69120 Heidelberg Germany

Glickman Urological and Kidney Institute Cleveland Clinic Cleveland OH 44195 USA

Hospital del Mar Institute of Medical Research Universitat Autònoma de Barcelona 08003 Barcelona Spain

Institute of Public Health and Preventive Medicine Charles University 2nd Faculty of Medicine 150 06 Prague 5 Czech Republic

International Agency for Research on Cancer 69372 Lyon France

ISGlobal Centre for Research in Environmental Epidemiology 08003 Barcelona Spain

Laboratory for Pharmacogenomics Biomedical Center Faculty of Medicine in Pilsen Charles University 323 00 Pilsen Czech Republic

Laboratory of Translational Genomics Division of Cancer Epidemiology and Genetics National Cancer Institute National Institutes of Health Bethesda MD 20892 USA

Lunenfeld Tanenbaum Research Institute of Mount Sinai Hospital Toronto Ontario M5G 1×5 Canada

National Center for Tumor Diseases 69120 Heidelberg Germany

Oncology Department ASL1 Massa Carrara Carrara 54033 Italy

Pancreas Unit Department of Digestive Diseases and Internal Medicine Sant'Orsola Malpighi Hospital 40138 Bologna Italy

Perlmutter Cancer Center New York University School of Medicine New York NY 10016 USA

Population Health Department QIMR Berghofer Medical Research Institute Brisbane 4029 Australia

School of Clinical Medicine University of Cambridge Cambridge CB2 0SP UK

SWOG Statistical Center Fred Hutchinson Cancer Research Center Seattle WA 98109 USA

Unit of Nutrition and Cancer Cancer Epidemiology Research Program Bellvitge Biomedical Research Institute Barcelona 08908 Spain

Universitat Pompeu Fabra 08002 Barcelona Spain

Yale Cancer Center New Haven CT 06510 USA

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