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Glycemic index, glycemic load, and the risk of pancreatic cancer among postmenopausal women in the women’s health initiative observational study and clinical trial

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Abstract

Background

Several reports have suggested that conditions associated with hyperinsulinemia and insulin resistance, such as diets high in carbohydrates, may influence the risk of pancreatic cancer, although results from prior studies have been mixed.

Methods

We utilized data from the population-based women’s health initiative (WHI) cohort to determine whether dietary factors that are associated with increased postprandial blood glucose levels are also associated with an increased risk of pancreatic cancer. The WHI included 161,809 postmenopausal women of ages 50–79, in which 332 cases of pancreatic cancer were identified over a median of 8 years of follow-up; 287 of these cases met the criteria for analysis. A validated 122-item food frequency questionnaire was used to estimate dietary glycemic load (GL), glycemic index (GI), total and available carbohydrates, fructose and sucrose. Baseline questionnaires and physical exams provided information on demographic, medical, lifestyle, and anthropometric characteristics. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between the exposures of interest and pancreatic cancer risk, with adjustment for potential confounders.

Results

Dietary GL, GI, carbohydrates, fructose, and sucrose were not associated with increased risk of pancreatic cancer. The multivariable adjusted HR for the highest vs. the lowest quartile of GL was 0.80 (95% CI = 0.55–1.15, trend p = 0.31) and 1.13 (95% CI = 0.78–1.63, trend p = 0.94) for GI. The results remained negative when individuals with a history of diabetes were excluded.

Conclusions

Our results do not support the hypothesis that dietary intake of carbohydrates is associated with increased risk of pancreatic cancer.

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Acknowledgments

Program Office:

(National Heart, Lung, and Blood Institute, Bethesda, Maryland) Jacques Rossouw, Shari Ludlam, Joan McGowan, Leslie Ford, and Nancy Geller.

Clinical Coordinating Center:

(Fred Hutchinson Cancer Research Center, Seattle, WA) Ross Prentice, Garnet Anderson, Andrea LaCroix, Charles L. Kooperberg; (Medical Research Labs, Highland Heights, KY) Evan Stein; (University of California at San Francisco, San Francisco, CA) Steven Cummings.

Clinical Centers:

(Albert Einstein College of Medicine, Bronx, NY) Sylvia Wassertheil-Smoller; (Baylor College of Medicine, Houston, TX) Haleh Sangi-Haghpeykar; (Brigham and Women's Hospital, Harvard Medical School, Boston, MA) JoAnn E. Manson; (Brown University, Providence, RI) Charles B. Eaton; (Emory University, Atlanta, GA) Lawrence S. Phillips; (Fred Hutchinson Cancer Research Center, Seattle, WA) Shirley Beresford; (George Washington University Medical Center, Washington, DC) Lisa Martin; (Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA) Rowan Chlebowski; (Kaiser Permanente Center for Health Research, Portland, OR) Erin LeBlanc; (Kaiser Permanente Division of Research, Oakland, CA) Bette Caan; (Medical College of Wisconsin, Milwaukee, WI) Jane Morley Kotchen; (MedStar Research Institute/Howard University, Washington, DC) Barbara V. Howard; (Northwestern University, Chicago/Evanston, IL) Linda Van Horn; (Rush Medical Center, Chicago, IL) Henry Black; (Stanford Prevention Research Center, Stanford, CA) Marcia L. Stefanick; (State University of New York at Stony Brook, Stony Brook, NY) Dorothy Lane; (The Ohio State University, Columbus, OH) Rebecca Jackson; (University of Alabama at Birmingham, Birmingham, AL) Cora E. Lewis; (University of Arizona, Tucson/Phoenix, AZ) Cynthia A. Thomson; (University at Buffalo, Buffalo, NY) Jean Wactawski-Wende; (University of California at Davis, Sacramento, CA) John Robbins; (University of California at Irvine, CA) F. Allan Hubbell; (University of California at Los Angeles, Los Angeles, CA) Lauren Nathan; (University of California at San Diego, LaJolla/Chula Vista, CA) Robert D. Langer; (University of Cincinnati, Cincinnati, OH) Margery Gass; (University of Florida, Gainesville/Jacksonville, FL) Marian Limacher; (University of Hawaii, Honolulu, HI) J. David Curb; (University of Iowa, Iowa City/Davenport, IA) Robert Wallace; (University of Massachusetts/Fallon Clinic, Worcester, MA) Judith Ockene; (University of Medicine and Dentistry of New Jersey, Newark, NJ) Norman Lasser; (University of Miami, Miami, FL) Mary Jo O’Sullivan; (University of Minnesota, Minneapolis, MN) Karen Margolis; (University of Nevada, Reno, NV) Robert Brunner; (University of North Carolina, Chapel Hill, NC) Gerardo Heiss; (University of Pittsburgh, Pittsburgh, PA) Lewis Kuller; (University of Tennessee Health Science Center, Memphis, TN) Karen C. Johnson; (University of Texas Health Science Center, San Antonio, TX) Robert Brzyski; (University of Wisconsin, Madison, WI) Gloria E. Sarto; (Wake Forest University School of Medicine, Winston-Salem, NC) Mara Vitolins; (Wayne State University School of Medicine/Hutzel Hospital, Detroit, MI) Michael S. Simon.

Women’s Health Initiative Memory Study:

(Wake Forest University School of Medicine, Winston-Salem, NC) Sally Shumaker.

Author information

Authors and Affiliations

  1. Karmanos Cancer Institute, Department of Oncology, Wayne State University, 4100 John R, 4221, HWCRC, Detroit, MI, USA

    M. S. Simon & J. Abrams

  2. Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, MI, USA

    M. S. Simon

  3. Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    J. M. Shikany

  4. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    M. L. Neuhouser

  5. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA

    T. Rohan

  6. Lone Star Cancer Associated, PA, San Antonio, TX, USA

    K. Nirmal

  7. Office of Health Assessment and Epidemiology, Los Angeles County Public Health Department, Los Angeles, CA, USA

    Y. Cui

Authors
  1. M. S. Simon
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  2. J. M. Shikany
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  3. M. L. Neuhouser
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  4. T. Rohan
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  5. K. Nirmal
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  6. Y. Cui
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  7. J. Abrams
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Correspondence to M. S. Simon.

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Simon, M.S., Shikany, J.M., Neuhouser, M.L. et al. Glycemic index, glycemic load, and the risk of pancreatic cancer among postmenopausal women in the women’s health initiative observational study and clinical trial. Cancer Causes Control 21, 2129–2136 (2010). https://doi.org/10.1007/s10552-010-9632-4

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  • DOI: https://doi.org/10.1007/s10552-010-9632-4

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