Cancer Causes & Control

, Volume 23, Issue 2, pp 371–378

Measured body mass index in adolescence and the incidence of pancreatic cancer in a cohort of 720,000 Jewish men

  • Zohar Levi
  • Jeremy D. Kark
  • Arnon Afek
  • Estela Derazne
  • Dorit Tzur
  • Moshe Furman
  • Barak Gordon
  • Micha Barchana
  • Irena Liphshitz
  • Yaron Niv
  • Ari Shamiss
Original paper

DOI: 10.1007/s10552-011-9886-5

Cite this article as:
Levi, Z., Kark, J.D., Afek, A. et al. Cancer Causes Control (2012) 23: 371. doi:10.1007/s10552-011-9886-5

Abstract

Purpose

The increasing prevalence of adolescent obesity affects adult health. We investigated the association of adolescent overweight with pancreatic cancer incidence in a cohort of 720,927 Jewish Israeli men.

Methods

Body mass index (BMI) was measured during a general health examination at ages 16–19 between the years 1967 and 1995. Overweight was defined as BMI ≥ 85th percentile of the reference US-CDC distribution in adolescence. Pancreatic cancer was identified by linkage with the Israel National Cancer Registry up to 2006.

Results

The mean follow-up period was 23.3 ± 8.0 years. During 16.8 million person-years, 98 cases of pancreatic cancer were detected. Using Cox proportional hazards modeling, overweight in adolescence predicted an increased risk of pancreatic cancer [hazard ratio (HR) = 2.09; 95% confidence interval (CI): 1.26–3.50, p = 0.005]. Compared with adolescents with ‘normal’ range BMI Z-scores (−1 to +1), adolescents with Z-scores > 1 showed significantly increased risk [HR, 2.28 (95% CI: 1.43–3.64), p = 0.001]. Lower education level (10 or less years of schooling vs. 11–12 years) was also associated with increased risk of pancreatic cancer [HR 1.90 (95% CI: 1.27–2.86, p = 0.002)], whereas height, country of origin and immigration status were not.

Conclusions

Adolescent overweight is substantially associated with pancreatic cancer incidence in young to middle-aged adults. Applying our point estimates to the 16.8% prevalence of excess weight in Israeli adolescents in the past decade suggests a population fraction of 15.5% (95% CI: 4.2–29.6%) for pancreatic cancer attributable to adolescent overweight in Israel.

Keywords

Adolescence Obesity Pancreatic cancer 

Abbreviations

BMI

Body mass index

US-CDC

United States Center for Disease Control

HR

Hazard ratio

CI

Confidence interval

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Zohar Levi
    • 1
    • 2
    • 3
  • Jeremy D. Kark
    • 4
  • Arnon Afek
    • 1
    • 3
    • 5
  • Estela Derazne
    • 1
    • 3
  • Dorit Tzur
    • 1
  • Moshe Furman
    • 1
  • Barak Gordon
    • 1
  • Micha Barchana
    • 6
  • Irena Liphshitz
    • 6
  • Yaron Niv
    • 2
    • 3
  • Ari Shamiss
    • 3
    • 5
  1. 1.Medical Corps, Israeli Defense ForceTel HashomerIsrael
  2. 2.The Gastroenterology DepartmentRabin Medical CenterPetach TikvaIsrael
  3. 3.Sackler Faculty of MedicineTel-Aviv UniversityTel AvivIsrael
  4. 4.Hebrew University-Hadassah School of Public Health and Community MedicineJerusalemIsrael
  5. 5.Sheba Medical CenterTel HashomerIsrael
  6. 6.The National Cancer RegistryJerusalemIsrael

Personalised recommendations