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Body mass index, effect modifiers, and risk of pancreatic cancer: a pooled study of seven prospective cohorts

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Abstract

Objective

To investigate whether the positive association of body mass index (BMI, kg/m2) with risk of pancreatic cancer is modified by age, sex, smoking status, physical activity, and history of diabetes.

Methods

In a pooled analysis of primary data of seven prospective cohorts including 458,070 men and 485,689 women, we identified 2,454 patients with incident pancreatic cancer during an average 6.9 years of follow-up. Cox proportional hazard regression models were used in data analysis.

Results

In a random-effects meta-analysis, for every 5 kg/m2 increment in BMI, the summary relative risk (RR) was 1.06 (95% confidence interval (CI) 0.99–1.13) for men and 1.12 (95% CI 1.05–1.19) for women. The aggregate analysis showed that compared with normal weight (BMI: 18.5 to <25), the adjusted RR was 1.13 (95% CI 1.03–1.23) for overweight (BMI: 25 to <30) and 1.19 (95% CI 1.05–1.35) for obesity class I (BMI: 30 to <35). Tests of interactions of BMI effects by other risk factors were not statistically significant. Every 5 kg/m2 increment in BMI was associated with an increased risk of pancreatic cancer among never and former smokers, but not among current smokers (P-interaction = 0.08).

Conclusion

The present evidence suggests that a high BMI is an independent risk factor of pancreatic cancer.

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Abbreviations

AARP:

National Institutes of Health-AARP Diet and Health Study

AHS:

Agricultural Health Study

ATBC:

Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study

BCDDP:

Breast Cancer Detection Demonstration Project

BMI:

Body mass index

CI:

Confidence interval

NCI-DCEG:

National Cancer Institute-Division of Cancer Epidemiology and Genetics

PLCO:

Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial

SD:

Standard deviation

SWHS:

Shanghai Women’s Health Study

RR:

Relative risk

USRT:

United States Radiologic Technologists Study

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Acknowledgments

The authors thank Jerome Mabie, Joe Barker, Matthew Butcher, Jeremy Miller, and Anne Taylor from the Information Management System for their help with data management.

Financial Support

The funding source of this pooled analysis is the Intramural Research Program of the National Cancer Institute, Division of Cancer Epidemiology and Genetics; and National Institute of Environment Health Sciences, Epidemiology Branch, National Institutes of Health.

Conflict of Interest

No conflict of interest is declared.

Author information

Authors and Affiliations

  1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Li Jiao, Amy Berrington de Gonzalez, Patricia Hartge, Ruth M. Pfeiffer, Yikyung Park, D. Michal Freedman, Mitchell H. Gail, Michael C. R. Alavanja, Demetrius Albanes, Laura E. Beane Freeman, Wong-Ho Chow, Wen-Yi Huang, Richard B. Hayes, Bu-tian Ji, Martha S. Linet, Cari L. Meinhold, Catherine Schairer, Arthur Schatzkin, Stephanie J. Weinstein & Rachael Z. Stolzenberg-Solomon

  2. Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA

    Jane A. Hoppin

  3. Department of Epidemiology and Preventive Medicine, Regensburg University Medical Center, Regensburg, Germany

    Michael F. Leitzmann

  4. Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland

    Jarmo Virtamo

  5. Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA

    Wei Zheng

  6. Department of Medicine, Baylor College of Medicine, 2002 Holcombe Blvd, box 152, Houston, TX, USA

    Li Jiao

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  1. Li Jiao
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  2. Amy Berrington de Gonzalez
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  23. Wei Zheng
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  24. Rachael Z. Stolzenberg-Solomon
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Corresponding author

Correspondence to Li Jiao.

Additional information

Writing group—Li Jiao, Amy Berrington de Gonzalez, Patricia Hartge, Ruth M. Pfeiffer, Yikyung Park, D. Michal Freedman, Mitchell H. Gail and Rachael Z. Stolzenberg-Solomon.

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Jiao, L., Berrington de Gonzalez, A., Hartge, P. et al. Body mass index, effect modifiers, and risk of pancreatic cancer: a pooled study of seven prospective cohorts. Cancer Causes Control 21, 1305–1314 (2010). https://doi.org/10.1007/s10552-010-9558-x

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  • DOI: https://doi.org/10.1007/s10552-010-9558-x

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