Cancer Causes & Control

, Volume 18, Issue 2, pp 165–175

Body mass index and physical activity as risk factors for pancreatic cancer: the Multiethnic Cohort Study

  • Ute Nöthlings
  • Lynne R. Wilkens
  • Suzanne P. Murphy
  • Jean H. Hankin
  • Brian E. Henderson
  • Laurence N. Kolonel
Original Paper

Abstract

Objective

To examine body mass index (BMI) and physical activity as risk factors for pancreatic cancer.

Methods

Eight-year prospective data from 77,255 men and 90,175 women including 237 and 235 pancreatic cancer cases, respectively, in the Hawaii-Los Angeles Multiethnic Cohort Study were analyzed. Participants completed a questionnaire that included questions on body weight, height, and physical activity. Cox proportional hazards models were calculated to estimate relative risks (RR) of pancreatic cancer by levels of BMI and total physical activity (as metabolic equivalents (METs)) adjusted for several potential confounders.

Results

Obesity (BMI ≥ 30 kg/m2) was associated with an increased pancreatic cancer risk in men (RR = 1.51 (95% CI: 1.02–2.26)), but a reduced risk in women (RR = 0.65 (95% CI: 0.43–0.99)). In men the risk was higher in never smokers than in current or former smokers, though differences were not statistically significant. Physical activity was not associated with pancreatic cancer risk in either men or women.

Conclusion

The findings suggest, that a BMI of ≥ 30 kg/m2 may be a risk factor for pancreatic cancer in men. No evidence of an effect of physical activity on risk was found.

Keywords

Prospective cohort Pancreatic cancer Physical activity Body mass index Obesity 

References

  1. 1.
    Jemal A, Clegg LX, Ward E et al (2004) Annual report to the nation on the status of cancer, 1975–2001, with a special feature regarding survival. Cancer 101(1):3–27PubMedCrossRefGoogle Scholar
  2. 2.
    American Cancer Society (2005) Cancer Facts and Figures 2005. American Cancer Society, AntlantaGoogle Scholar
  3. 3.
    Li D, Xie K, Wolff R et al (2004) Pancreatic cancer. Lancet 363(9414):1049–1057PubMedCrossRefGoogle Scholar
  4. 4.
    Huxley R, Ansary-Moghaddam A, Berrington dG et al (2005) Type-II diabetes and pancreatic cancer: a meta-analysis of 36 studies. Br J Cancer 92:2076–2083PubMedCrossRefGoogle Scholar
  5. 5.
    Batty GD, Shipley MJ, Marmot M et al (2004) Diabetes status and post-load plasma glucose concentration in relation to site-specific cancer mortality: findings from the original Whitehall study. Cancer Causes Control 15(9):873–881PubMedCrossRefGoogle Scholar
  6. 6.
    Klein AP, Brune KA, Petersen GM et al (2004) Prospective risk of pancreatic cancer in familial pancreatic cancer kindreds. Cancer Res 64(7):2634–2638PubMedCrossRefGoogle Scholar
  7. 7.
    Calle EE, Murphy TK, Rodriguez C et al (1998) Diabetes mellitus and pancreatic cancer mortality in a prospective cohort of United States adults. Cancer Causes Control 9(4):403–410PubMedCrossRefGoogle Scholar
  8. 8.
    Everhart J, Wright D (1995) Diabetes mellitus as a risk factor for pancreatic cancer. A meta-analysis. JAMA 273(20):1605–1609PubMedCrossRefGoogle Scholar
  9. 9.
    Vimalachandran D, Ghaneh P, Costello E et al (2004) Genetics and prevention of pancreatic cancer. Cancer Control 11(1):6–14PubMedGoogle Scholar
  10. 10.
    Silverman DT (2001) Risk factors for pancreatic cancer: a case-control study based on direct interviews. Teratog Carcinog Mutagen 21(1):7–25PubMedCrossRefGoogle Scholar
  11. 11.
    Shibata A, Mack TM, Paganini-Hill A et al (1994) A prospective study of pancreatic cancer in the elderly. Int J Cancer 58(1):46–49PubMedGoogle Scholar
  12. 12.
    Stolzenber-Solomon RZ, Pietinen P, Taylor PR et al (2002) A prospective study of medical conditions, anthropometry, physical activity, and pancreatic cancer in male smokers (Finland). Cancer Causes Control 13(5):417–426CrossRefGoogle Scholar
  13. 13.
    Ghadirian P, Lynch HT, Krewski D (2003) Epidemiology of pancreatic cancer: an overview. Cancer Detect Prev 27(2):87–93PubMedCrossRefGoogle Scholar
  14. 14.
    Edwards BK, Brown ML, Wingo PA et al (2005) Annual report to the nation on the status of cancer, 1975–2002, featuring population-based trends in cancer treatment. J Natl Cancer Inst 97(19):1407–1427PubMedGoogle Scholar
  15. 15.
    Key TJ, Schatzkin A, Willett WC et al (2004) Diet, nutrition and the prevention of cancer. Public Health Nutr 7(1A):187–200PubMedCrossRefGoogle Scholar
  16. 16.
    Lowenfels AB, Maisonneuve P (2004) Epidemiology and prevention of pancreatic cancer. Jpn J Clin Oncol 34(5):238–244PubMedCrossRefGoogle Scholar
  17. 17.
    Berrington dG, Sweetland S, Spencer E (2003) A meta-analysis of obesity and the risk of pancreatic cancer. Br J Cancer 89(3):519–523CrossRefGoogle Scholar
  18. 18.
    Wang F, Herrington M, Larsson J et al (2003) The relationship between diabetes and pancreatic cancer. Mol Cancer 2(1):4–8PubMedCrossRefGoogle Scholar
  19. 19.
    Fisher WE, Boros LG, Schirmer WJ (1996) Insulin promotes pancreatic cancer: evidence for endocrine influence on exocrine pancreatic tumors. J Surg Res 63(1):310–313PubMedCrossRefGoogle Scholar
  20. 20.
    Gapstur SM, Gann PH, Lowe W et al (2000) Abnormal glucose metabolism and pancreatic cancer mortality. JAMA 283(19):2552–2558PubMedCrossRefGoogle Scholar
  21. 21.
    McCarty MF (2001) Insulin secretion as a determinant of pancreatic cancer risk. Med Hypotheses 57(2):146–150PubMedCrossRefGoogle Scholar
  22. 22.
    Stolzenberg-Solomon RZ, Graubard BI, Chari S et al (2005) Insulin, glucose, insulin resistance, and pancreatic cancer in male smokers. JAMA 294(22):2872–2878PubMedCrossRefGoogle Scholar
  23. 23.
    Steyn NP, Mann J, Bennett PH et al (2004) Diet, nutrition and the prevention of type 2 diabetes. Public Health Nutr 7(1A):147–165PubMedCrossRefGoogle Scholar
  24. 24.
    Kolonel LN, Henderson BE, Hankin JH et al (2000) A multiethnic cohort in Hawaii and Los Angeles: baseline characteristics. Am J Epidemiol 151(4):346–357PubMedGoogle Scholar
  25. 25.
    Stram DO, Hankin JH, Wilkens LR et al (2000) Calibration of the dietary questionnaire for a multiethnic cohort in Hawaii and Los Angeles. Am J Epidemiol 151(4):358–370PubMedGoogle Scholar
  26. 26.
    Insitute of Medicine (2002) Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, amino acids. National Academics Press, Washington DCGoogle Scholar
  27. 27.
    Physical status: the use and interpretation of anthropometry (1995) Report of a WHO Expert CommitteeGoogle Scholar
  28. 28.
    Nothlings U, Wilkens LR, Murphy SP et al (2005) Meat and fat intake as risk factors for pancreatic cancer: the multiethnic cohort study. J Natl Cancer Inst 97(19):1458–1465PubMedCrossRefGoogle Scholar
  29. 29.
    Samanic C, Gridley G, Chow WH et al (2004) Obesity and cancer risk among white and black United States veterans. Cancer Causes Control 15(1):35–43PubMedCrossRefGoogle Scholar
  30. 30.
    Coughlin SS, Calle EE, Patel AV et al (2000) Predictors of pancreatic cancer mortality among a large cohort of United States adults. Cancer Causes Control 11(10):915–923PubMedCrossRefGoogle Scholar
  31. 31.
    Calle EE, Rodriguez C, Walker-Thurmond K et al (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 348(17):1625–1638PubMedCrossRefGoogle Scholar
  32. 32.
    Berrington dG, Spencer EA, Bueno-de-Mesquita HB et al (2006) Anthropometry, physical activity, and the risk of pancreatic cancer in the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomarkers Prev 15(5):879–885CrossRefGoogle Scholar
  33. 33.
    Michaud DS, Giovannucci E, Willett WC et al (2001) Physical activity, obesity, height, and the risk of pancreatic cancer. JAMA 286(8):921–929PubMedCrossRefGoogle Scholar
  34. 34.
    Patel AV, Rodriguez C, Bernstein L et al (2005) Obesity, recreational physical activity, and risk of pancreatic cancer in a large U.S. Cohort. Cancer Epidemiol Biomarkers Prev 14(2):459–466PubMedCrossRefGoogle Scholar
  35. 35.
    Nilsen TI, Vatten LJ (2000) A prospective study of lifestyle factors and the risk of pancreatic cancer in Nord-Trondelag, Norway. Cancer Causes Control 11(7):645–652PubMedCrossRefGoogle Scholar
  36. 36.
    Sinner PJ, Schmitz KH, Anderson KE et al (2005) Lack of association of physical activity and obesity with incident pancreatic cancer in elderly women. Cancer Epidemiol Biomarkers Prev 14(6):1571–1573PubMedCrossRefGoogle Scholar
  37. 37.
    Lee IM, Sesso HD, Oguma Y et al (2003) Physical activity, body weight, and pancreatic cancer mortality. Br J Cancer 88(5):679–683PubMedCrossRefGoogle Scholar
  38. 38.
    Wolk A, Gridley G, Svensson M et al (2001) A prospective study of obesity and cancer risk (Sweden). Cancer Causes Control 12(1):13–21PubMedCrossRefGoogle Scholar
  39. 39.
    Isaksson B, Jonsson F, Pedersen NL et al (2002) Lifestyle factors and pancreatic cancer risk: a cohort study from the Swedish Twin Registry. Int J Cancer 98(3):480–482PubMedCrossRefGoogle Scholar
  40. 40.
    Larsson SC, Permert J, Hakansson N et al (2005) Overall obesity, abdominal adiposity, diabetes and cigarette smoking in relation to the risk of pancreatic cancer in two Swedish population-based cohorts. Br J Cancer 93(11):1310–1315PubMedCrossRefGoogle Scholar
  41. 41.
    Eberle CA, Bracci PM, Holly EA (2005) Anthropometric factors and pancreatic cancer in a population-based case-control study in the San Francisco Bay Area. Cancer Causes Control 16(10):1235–1244PubMedCrossRefGoogle Scholar
  42. 42.
    Hanley AJ, Johnson KC, Villeneuve PJ et al (2001) Physical activity, anthropometric factors and risk of pancreatic cancer: results from the Canadian enhanced cancer surveillance system. Int J Cancer 94(1):140–147PubMedCrossRefGoogle Scholar
  43. 43.
    Bueno de Mesquita HB, Moerman CJ, Runia S et al (1990) Are energy and energy-providing nutrients related to exocrine carcinoma of the pancreas? Int J Cancer 46(3):435–444PubMedGoogle Scholar
  44. 44.
    Fryzek JP, Schenk M, Kinnard M et al (2005) The association of body mass index and pancreatic cancer in residents of southeastern michigan, 1996–1999. Am J Epidemiol 162(3):222–228PubMedCrossRefGoogle Scholar
  45. 45.
    Ji BT, Hatch MC, Chow WH et al (1996) Anthropometric and reproductive factors and the risk of pancreatic cancer: a case-control study in Shanghai, China. Int J Cancer 66(4):432–437PubMedCrossRefGoogle Scholar
  46. 46.
    Lyon JL, Slattery ML, Mahoney AW et al (1993) Dietary intake as a risk factor for cancer of the exocrine pancreas. Cancer Epidemiol Biomarkers Prev 2(6):513–518PubMedGoogle Scholar
  47. 47.
    Pan SY, Johnson KC, Ugnat AM et al (2004) Association of obesity and cancer risk in Canada. Am J Epidemiol 159(3):259–268PubMedCrossRefGoogle Scholar
  48. 48.
    Silverman DT, Swanson CA, Gridley G et al (1998) Dietary and nutritional factors and pancreatic cancer: a case-control study based on direct interviews. J Natl Cancer Inst 90(22):1710–1719PubMedCrossRefGoogle Scholar
  49. 49.
    Ghadirian P, Simard A, Baillargeon J et al (1991) Nutritional factors and pancreatic cancer in the francophone community in Montreal, Canada. Int J Cancer 47(1):1–6PubMedGoogle Scholar
  50. 50.
    Howe GR, Jain M, Miller AB (1990) Dietary factors and risk of pancreatic cancer: results of a Canadian population-based case-control study. Int J Cancer 45(4):604–608PubMedGoogle Scholar
  51. 51.
    Pezzilli R, Morselli-Labate AM, Migliori M et al (2005) Obesity and the risk of pancreatic cancer: an italian multicenter study. Pancreas 31(3):221–224PubMedCrossRefGoogle Scholar
  52. 52.
    Pi-Sunyer FX (2004) The epidemiology of central fat distribution in relation to disease. Nutr Rev 62(7 Pt 2):S120–S126PubMedCrossRefGoogle Scholar
  53. 53.
    Teras LR, Patel AV, Rodriguez C et al (2005) Parity, other reproductive factors, and risk of pancreatic cancer mortality in a large cohort of U.S. Women (United States). Cancer Causes Control 16(9):1035–1040PubMedCrossRefGoogle Scholar
  54. 54.
    Skinner HG, Michaud DS, Colditz GA et al (2003) Parity, reproductive factors, and the risk of pancreatic cancer in women. Cancer Epidemiol Biomarkers Prev 12(5):433–438PubMedGoogle Scholar
  55. 55.
    Lee IM, Paffenbarger RS Jr (1994) Physical activity and its relation to cancer risk: a prospective study of college alumni. Med Sci Sports Exerc 26(7):831–837PubMedGoogle Scholar
  56. 56.
    Batty GD, Shipley MJ, Marmot M et al (2001) Physical activity and cause-specific mortality in men: further evidence from the Whitehall study. Eur J Epidemiol 17(9):863–869PubMedCrossRefGoogle Scholar
  57. 57.
    Davey SG, Shipley MJ, Batty GD et al (2000) Physical activity and cause-specific mortality in the Whitehall study. Public Health 114(5):308–315CrossRefGoogle Scholar
  58. 58.
    Inoue M, Tajima K, Takezaki T et al (2003) Epidemiology of pancreatic cancer in Japan: a nested case-control study from the Hospital-based Epidemiologic Research Program at Aichi Cancer Center (HERPACC). Int J Epidemiol 32(2):257–262PubMedCrossRefGoogle Scholar
  59. 59.
    Villanueva EV (2001) The validity of self-reported weight in US adults: a population based cross-sectional study. BMC Public Health 1(1):11PubMedCrossRefGoogle Scholar
  60. 60.
    Spencer EA, Appleby PN, Davey GK et al (2002) Validity of self-reported height and weight in 4808 EPIC-Oxford participants. Public Health Nutr 5(4):561–565PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Ute Nöthlings
    • 1
  • Lynne R. Wilkens
    • 1
  • Suzanne P. Murphy
    • 1
  • Jean H. Hankin
    • 1
  • Brian E. Henderson
    • 2
  • Laurence N. Kolonel
    • 1
  1. 1.Cancer Research Center of HawaiiUniversity of HawaiiHonoluluUSA
  2. 2.University of Southern CaliforniaLos AngelesUSA

Personalised recommendations