Cancer Causes & Control

, Volume 4, Issue 5, pp 477–482 | Cite as

A cohort study of smoking, alcohol consumption, and dietary factors for pancreatic cancer (United States)

  • Wei Zheng
  • Joseph K. McLaughlin
  • Gloria Gridley
  • Erik Bjelke
  • Leonard M. Schuman
  • Debra T. Silverman
  • Sholom Wacholder
  • Harvey T. Co-Chien
  • William J. Blot
  • Joseph F. FraumeniJr.
Research Paper

Risk factors for pancreatic cancer were evaluated in a cohort study of 17,633 White men in the United States who responded to a mailed questionnaire in 1966 and were followed-up through 1986 for mortality. Cigarette smoking and alcohol consumption were found to be important risk factors for pancreatic cancer. Risks increased significantly with number of cigarettes smoked, reaching fourfold for smokers of 25 or more cigarettes per day relative to nonsmokers. Alcohol intake also was related significantly to risk, with consumers of 10 or more drinks per month having three times the risk of nondrinkers, but dose-response trends among drinkers were not smooth. Coffee consumption was unrelated to risk. Dietaryanalyses revealed a rising rate of pancreatic cancer mortality with increasing consumption of meat after adjustment for other risk factors. Men in the highest quartile of meat intake had about three times the risk of those in the lowest quartile. No consistent association, however, was observed for consumption of fruits, vegetables, or grains. This study confirms cigarette smoking as an important risk factor for pancreatic cancer, and provides evidence that elevated intake of alcohol and meat may increase the risk of this fatal malignancy.

Key words

Alcohol drinking coffee cohort study diet mortality pancreatic neoplasm tobacco United States White males 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Fontham ETH, Correa P. Epidemiology of pancreatic cancer. Surg Clin North America 1989; 69: 551–67.Google Scholar
  2. 2.
    Boyle P, Hsieh C-c, Maisonneuve P, et al. Epidemiology of pancreas cancer (1988). Int J Pancreatol 1989; 5: 327–46.Google Scholar
  3. 3.
    Howe GR, Jain M, Burch JD, et al. Cigarette smoking and cancer of the pancreas: Evidence from a population-based case-control study in Toronto, Canada. Int J Cancer 1991; 47: 323–8.Google Scholar
  4. 4.
    Bueno de Mesquita HB, Maisonneuve P, Moerman CJ, et al. Life-time history of smoking and exocrine carcinoma of the pancreas: A population-based case-control study in the Netherlands. Int J Cancer 1991; 49: 816–22.Google Scholar
  5. 5.
    Farrow DC, Davis S. Risk of pancreatic cancer in relation to medical history and the use of tobacco, alcohol and coffee. Int J Cancer 1990; 45: 816–20.Google Scholar
  6. 6.
    Olsen GW, Mandel JS, Gibson RW, et al. A case-control study of pancreatic cancer and cigarettes, alcohol, coffee and diet. Am J Public Health 1989; 79: 1016–9.Google Scholar
  7. 7.
    Zatonski WA, Boyle P, Przewozniak K, et al. Cigarette smoking, alcohol, tea and coffee consumption and pancreas cancer risk: A case-control study from Opole, Poland. Int J Cancer 1993; 601–7.Google Scholar
  8. 8.
    Friedman GD, Van DenEeden SK. Risk factors for pancreatic cancer: An exploratory study. Int J Epidemiol 1993; 22: 30–7.Google Scholar
  9. 9.
    Mack TM, Yu MC, Hanisch R, et al. Pancreas cancer and smoking, beverage consumption and past medical history. JNCI 1986; 76: 49–60.Google Scholar
  10. 10.
    Falk RT, Pickle LW, Fontham ET et al. Life-style risk factors for pancreatic cancer in Louisiana: A case-control study. Am J Epidemiol 1988; 128: 324–36.Google Scholar
  11. 11.
    Norell SE, Ahlbom A, Erwald R, et al. Diet and pancreatic cancer: A case-control study. Am J Epidemiol 1986; 124: 894–902.Google Scholar
  12. 12.
    Farrow DC, Davis S. Diet and the risk of pancreatic cancer in men. Am J Epidemiol 1990; 132: 423–31.Google Scholar
  13. 13.
    Ghadirian P, Simard A, Baillargeion J, et al. Nutritional factors and pancreatic cancer in the Francophone Community in Montreal, Canada. Int J Cancer 1991; 47: 1–6.Google Scholar
  14. 14.
    Durbec JP, Chevillotte G, Bidort JM, et al. Diet, alcohol, tobacco and risk of cancer of the pancreas: A case-control study. Br J Cancer 1983; 47: 463–70.Google Scholar
  15. 15.
    LaVecchia C, Negri E, D'Avanzo B, et al. Medical history, diet and pancreatic cancer. Oncology 1990; 47: 463–6.Google Scholar
  16. 16.
    Baghurst PA, McMichael AJ, Slavotinek AH, et al. A case-control study of diet and cancer of the pancreas. Am J Epidemiol 1991; 134: 167–79.Google Scholar
  17. 17.
    Gold EB, Gordis L, Diener MD, et al. Diet and other risk factors for cancer of the pancreas. Cancer 1985; 55: 460–7.Google Scholar
  18. 18.
    Howe GR, Ghadirian P, Bueno de Mesquita HB, et al. A collaborative case-control study of nutrient intake and pancreatic cancer within the SEARCH Programme. Int J Cancer 1992; 51: 365–72.Google Scholar
  19. 19.
    Velema JP, Walker AM, Gold EB. Alcohol and pancreatic cancer: Insufficient epidemiologic evidence for a causal relationship. Epidemiol Rev 1986; 8: 28–41.Google Scholar
  20. 20.
    Gordis L. Consumption of methylxanthine-containing beverages and risk of pancreatic cancer. Cancer Letters 1990; 52: 1–12.Google Scholar
  21. 21.
    World Health Organization. International Classification of Diseases, Ninth Revision. Geneva: WHO, 1977.Google Scholar
  22. 22.
    National Center for Health Statistics. Plan and Operation of the Second National Health and Nutrition Examination Survey, 1976–80. Hyattsville, MD: US Department of Health and Human Services, 1981; Vital and Health Statistics, Programs and Collection Procedures, Series 1, No. 15.Google Scholar
  23. 23.
    US Department of Agriculture. Composition of Foods: Raw, Processed, Prepared. Washington, DC: US Government Printing Office, 1976–1983; Agriculture Handbooks Nos. 8–1 to 8–10.Google Scholar
  24. 24.
    Preston DL, Kopecky KJ, Kato H. Analysis of mortality and disease incidence among atomic bomb survivors. In: Blot WJ, Hirayama T, Hoel DG, eds. Statistical Methods in Cancer Epidemiology. Hiroshima, Japan: Radiation Effects Research Foundation, 1985: 109–27.Google Scholar
  25. 25.
    Breslow NE, Day NE. Statistical Methods in Cancer Research, Vol. 2. Lyon, France: International Agency for Research on Cancer, 1987; IARC Sci. Pub. No. 82: 120–76.Google Scholar
  26. 26.
    Bjelke E, Schuman LM. Chewing tobacco and use of snuff: Relationship to cancer of the pancreas and other sites in two prospective studies [Abstract]. In: Proceedings of the 13th International Cancer Congress. Seattle, Washington, 1982: 207.Google Scholar
  27. 27.
    Heuch I, Kvale G, Jacobsen BK, et al. Use of alcohol, tobacco and coffec and risk of pancreatic cancer. Br J Cancer 1983; 48: 637–43.Google Scholar
  28. 28.
    Ghadirian P, Simard A, Baillargeion J. Tobacco, alcohol, and coffee and cancer of the pancreas. Cancer 1991; 67: 2664–70.Google Scholar
  29. 29.
    Jain M, Howe GR, St. Louis P, et al. Coffee and alcohol as determinants of pancreas cancer. A case-control study from Toronto. Int J Cancer 1991; 47: 384–9.Google Scholar
  30. 30.
    Bueno de Mesquita HB, Maisonneuve P, Moerman CJ, et al. Lifetime consumption of alcoholic beverages, tea, and coffee and exocrine carcinoma of the pancreas: A population-based case-control study in the Netherlands. Int J Cancer 1992; 50: 514–22.Google Scholar
  31. 31.
    Hirayama T. Epidemiology of pancreatic cancer in Japan. Jpn J Clin Oncol 1989; 19: 208–15.Google Scholar
  32. 32.
    Adami HO, McLaughlin JK, Hsing AW, et al. Alcoholism and cancer risk: A population-based cohort study. Cancer Causes Control 1992; 3: 419–25.Google Scholar
  33. 33.
    Bouchardy C, Clavel F, LaVecchia C, et al. Alcohol, beer and cancer of the pancreas. Int J Cancer 1990; 45: 842–6.Google Scholar
  34. 34.
    Lyon JL, Mahoney AW, French TK, et al. Coffee consumption and the risk of cancer of the exocrine pancreas: A case-control study in a low-risk population. Epidemiol 1992; 3: 164–70.Google Scholar
  35. 35.
    Cuzick J, Babiker AG. Pancreatic cancer, alcohol, diabetes mellitus and gallbladder disease. Int J Cancer 1989; 43: 415–21.Google Scholar
  36. 36.
    Liang JD, Gao YT, Zheng W, et al. A case-control study of pancreatic cancer in Shanghai urban area. Tumor (Shanghai) 1988; 8: 59–62.Google Scholar
  37. 37.
    Haddock G, Carter DC. Aetiology of pancreatic cancer. Br J Surg 1990; 77: 1159–66.Google Scholar
  38. 38.
    Mills PK, Beeson L, Abbey DE, et al. Dietary habits and past medical history as related to fatal pancreas cancer risk among Adventists. Cancer 1988; 61: 2578–85.Google Scholar
  39. 39.
    Raymond L, Infante F, Tuyns AJ, et al. Alimentation et cancer du pancreas. Gastroenterol Clin Biol 1987; 11: 488–92.Google Scholar
  40. 40.
    Friedenreich CM, Slimani N, Riboli E. Measurement of past diet: Review of previous and proposed methods. Epidemiol Rev 1992; 14: 177–96.Google Scholar
  41. 41.
    Poston GL, Gillespie J, Guillou PJ. Biology of pancreatic cancer. Gut 1991; 32: 800–12.Google Scholar
  42. 42.
    Howatson AG, Carter DC. Pancreatic carcinogenesis: Enhancement by cholecystokinin in the hamster-nitrosamine model. Br J Cancer 1985; 51: 107.Google Scholar
  43. 43.
    Adamson RH. Mutagens and carcinogens formed during cooking foods and methods to minimize their formation. In: DeVita VJr, Hellman S, Rosenberg SA, eds. Cancer Prevention. Philadelphia, PA: Lippincott, 1990: 1–7.Google Scholar
  44. 44.
    Fiore MC, Novotny TE, Pierce JP, et al. Trends in cigarette smoking in the United States. JAMA 1989; 261: 49–55.Google Scholar
  45. 45.
    Hsing AW, McLaughlin JK, Schuman LM, et al. Diet, tobacco use, and fatal prostate cancer: Results from the Lutheran Brotherhood cohort study. Cancer Res 1990; 50: 6836–40.Google Scholar
  46. 46.
    Snowdon DA. Alcohol use and mortalilty from cancer and heart disease among members of the Lutheran Brotherhood cohort. PhD dissertation, University of Minnesota (USA), 1981.Google Scholar

Copyright information

© Rapid Communications of Oxford Ltd 1993

Authors and Affiliations

  • Wei Zheng
  • Joseph K. McLaughlin
  • Gloria Gridley
  • Erik Bjelke
  • Leonard M. Schuman
  • Debra T. Silverman
  • Sholom Wacholder
  • Harvey T. Co-Chien
  • William J. Blot
  • Joseph F. FraumeniJr.

There are no affiliations available

Personalised recommendations