In multivariable conditional logistic regression analysis, which adjusted for potential confounders including hypertension, diabetes mellitus, coronary artery disease, chronic kidney disease, and mental disorders, acute exposure to AChE inhibitor insecticide was associated with more than a twofold increased risk of pancreatic cancer compared with the control group (adjusted HR, 2.57; 95% CI, 1.15–5.75). This evidence concerns the gene ACHE and coronary artery disorder.