Dietary and Nutritional Factors and Pancreatic Cancer: a Case-Control Study Based on Direct Interviews

Silverman, Debra T.; Swanson, Christine A.; Gridley, Gloria; Wacholder, Sholom; Greenberg, Raymond S.; Brown, Linda Morris; Hayes, Richard B.; Swanson, G. Marie; Schoenberg, Janet B.; Pottern, Linda M.; Schwartz, Ann G.; Fraumeni, Joseph F.; Hoover, Robert N.

doi:10.1093/jnci/90.22.1710

Cited by 241 publications

(172 citation statements)

References 40 publications

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“…Overall six case -control (Bueno de Mesquita et al, 1990;Howe et al, 1990;Ghadirian et al, 1991;Zatonski et al, 1991;Silverman et al, 1998;Hanley et al, 2001) and eight cohort studies (Friedman and van den Eeden, 1993;Shibata et al, 1994;Gapstur et al, 2000;Michaud et al, 2001;Stolzenberg-Solomon et al, 2002;Calle et al, 2003;Lee et al, 2003) were eligible for inclusion in this metaanalysis. In total, these studies included 6391 cases of pancreatic cancer ( Table 1).…”

Section: Resultsmentioning

confidence: 99%

A meta-analysis of obesity and the risk of pancreatic cancer

2003

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Smoking and diabetes are the only established risk factors for pancreatic cancer. Findings from recent studies suggest that obesity may also be associated with an increased risk of pancreatic cancer, but several earlier studies were less conclusive. We examined this relationship in a meta-analysis of published data. Six case -control and eight cohort studies involving 6391 cases of pancreatic cancer were identified from a computer-based literature search from 1966 to 2003. The relative risk per unit increase in body mass index was estimated for each of the studies from the published data. In a random effects model, the summary relative risk per unit increase in body mass index was 1.02 (95% CI: 1.01 -1.03). There was some evidence of heterogeneity between the studies' results (P ¼ 0.1). The summary relative risk estimates were slightly higher for studies that had adjusted for smoking and for case -control studies that had not used proxy respondents. The estimated per unit increase in body mass index would translate into a relative risk of 1.19 (95% CI: 1.10 -1.29) for obese people (30 kg m À2 ) compared to people with a normal body weight (22 kg m À2 ). These results provide evidence that the risk of pancreatic cancer may be weakly associated with obesity. However, the small magnitude of the summary risk means the possibility of confounding cannot be excluded. British Journal of Cancer (2003) Pancreatic cancer is the fifth most common cause of cancer mortality in the European Union and North America and is responsible for approximately 70 000 deaths in these regions annually (Ferlay et al, 2001). Smoking and diabetes are the only well-established risk factors for this invariably fatal disease (Gapstur and Gann, 2001). Smoking, however, is thought to account for at most 20 -40% of pancreatic cancer cases (International Agency for Research on Cancer, 1990). The findings from several large US cohort studies suggest that obesity (defined as body mass index of at least 30 kg m À2 ) may also be a risk factor for pancreatic cancer (Michaud et al, 2001;Calle et al, 2003). The results of several earlier observational studies were less conclusive. The aim of this meta-analysis was to examine the relationship between pancreatic cancer and body mass index in relevant published epidemiological studies. MATERIALS AND METHODS Data sourcesEpidemiological studies were identified through searches of the electronic databases MEDLINE (1966MEDLINE ( -2003, EMBASE (1980EMBASE ( -2003 and the Science Citation Index (1981 -2003) and also from citations in the selected papers and review articles. The key words that were used for the search were pancreatic cancer, obesity, body mass index, anthropometric factors and risk factors. The search was limited to human studies and restricted to peer-reviewed articles. No language or date limitations were imposed. Study selectionEach study was required to have published information on the number of study participants and on age-adjusted or age-matched relative risks (or odds ratios, subsequen...

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Section: Resultsmentioning

confidence: 99%

A meta-analysis of obesity and the risk of pancreatic cancer

2003

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“…Finally, it is also plausible that susceptibility to meat mutagens may vary by gender; however, sex-related differences in pancreatic cancer incidence and risk are thought to be related to differences in exposure and diagnosis (1). Other epidemiologic meat studies that have examined sexspecific pancreatic cancer risks have not shown clear sex differences (4,7,8,15,21,25,27,(29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

“…The association between meat intake and pancreatic cancer has been examined in both case control and cohort (23)(24)(25)(26)(27)(28)(29)(30)(31)(32) studies with positive (2-7, 9-12, 22-27), inverse (13)(14)(15)28), and null (4, 5, 8, 14-21, 29, 32) associations reported for both study designs. The inconsistent results among case-control studies may partly be due to retrospective ascertainment of diet, which, given the rapid fatality of pancreatic cancer, may be fraught with biases, such as recall and proxy, and reverse causation.…”

Section: Introductionmentioning

confidence: 99%

Meat and Meat-Mutagen Intake and Pancreatic Cancer Risk in the NIH-AARP Cohort

Stolzenberg‐Solomon¹,

Cross²,

Silverman³

et al. 2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Meat intake, particularly red meat, has been positively associated with pancreatic cancer in some epidemiologic studies. Detailed meat-cooking methods and related mutagens formed in meat cooked at high temperatures have not been evaluated prospectively as risk factors for this malignancy. We investigated the association between meat, meat-cooking methods, meat-mutagen intake, and exocrine pancreatic cancer in the NIH-American Association of Retired Persons (NIH-AARP) Diet and Health Study cohort of 537,302 individuals, aged 50 to 71 years, with complete baseline dietary data (1995)(1996) ascertained from a food frequency questionnaire. A meat-cooking module was completed by 332,913 individuals 6 months after baseline. During 5 years of follow-up, 836 incident pancreatic cancer cases (555 men, 281 women) were identified. Four hundred and fifty-nine cases had complete meat module data. We used Cox proportional hazard models to calculate hazard ratios (HR) and 95% confidence intervals (CI). Total, red, and high-temperature cooked meat intake was positively associated with pancreatic cancer among men (fifth versus first quintile: HR, 1.41, 95% CI, 1.08-1.83, P trend = 0.001; HR, 1.42, 95% CI, 1.05-1.91, P trend = 0.01; and HR, 1.52, 95% CI, 1.12-2.06, P trend = 0.005, respectively), but not women. Men showed significant 50% increased risks for the highest tertile of grilled/barbecued and broiled meat and significant doubling of risk for the highest quintile of overall meat-mutagenic activity (P trends < 0.01). The fifth quintile of the heterocyclic amine, 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline intake showed a significant 29% (P trend = 0.006) increased risk in men and women combined. These findings support the hypothesis that meat intake, particularly meat cooked at high temperatures and associated mutagens, may play a role in pancreatic cancer development. (Cancer Epidemiol Biomarkers Prev 2007;16(12):2664 -75)

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“…Our findings are in agreement with those of five previous case -control studies that reported statistically significant or borderline decreased risks of pancreatic cancer with higher saturated fat intake, with a relative risk of 0.3 (95% CI 0.1 -0.8), 0.3 (95% CI 0.1 -1.0), 0.2 (95% CI 0.1 -0.2), and 0.9 (P-trend ¼ 0.028; for men) for intakes in the highest as compared to the lowest quartiles (Baghurst et al, 1991;Bueno de Mesquita et al, 1991;Zatonski et al, 1991;Silverman et al, 1998), respectively. A large collaborative population-based case -control of pancreatic cancer comprising 802 cases from five countries in the Surveillance of Environmental Aspects Related to Cancers in Humans (SEARCH) Study found a nonsignificant reduced risk, with an overall OR of 0.8 (95% CI 0.6 -1.2) for the highest quartile of saturated fat intake (Howe et al, 1992), with significant inverse associations reported in two study centres (Howe and Burch, 1996).…”

Section: Discussionmentioning

confidence: 99%

“…Although no association with total or saturated fat intake has been found (Farrow and Davis, 1990;Kalapothaki et al, 1993), a significant decrease in risk with higher saturated (Bueno de Mesquita et al, 1990Zatonski et al, 1991;Ji et al, 1995;Silverman et al, 1998), monounsaturated (Bueno de Mesquita et al, 1990;Zatonski et al, 1991), and polyunsaturated (Zatonski et al, 1991) fat intake has been reported. A recent cohort study found no significant association in relation to specific FAs (Michaud et al, 2003), but included less than 180 cases over 18 years of follow-up.…”

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confidence: 99%

Specific fatty acid intake and the risk of pancreatic cancer in Canada

et al. 2005

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The possible association of specific fatty acid (FA) intake and pancreatic cancer risk was investigated in a population-based casecontrol study of 462 histologically confirmed cases and 4721 frequency-matched controls in eight Canadian provinces between 1994 and 1997. Dietary intake was assessed by means of a self-administered food frequency questionnaire. Unconditional logistic regression was used to assess associations between dietary FAs and pancreatic cancer risk. After adjustment for age, province, body mass index, smoking, educational attainment, fat and total energy intake, statistically significant inverse associations were observed between pancreatic cancer risk and palmitate (odds ratios (ORs) ¼ 0.73; 95% confidence intervals (CIs) 0.56 -0.96; P-trend ¼ 0.

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Dietary and Nutritional Factors and Pancreatic Cancer: a Case-Control Study Based on Direct Interviews

Cited by 241 publications

References 40 publications

A meta-analysis of obesity and the risk of pancreatic cancer

A meta-analysis of obesity and the risk of pancreatic cancer

Meat and Meat-Mutagen Intake and Pancreatic Cancer Risk in the NIH-AARP Cohort

Specific fatty acid intake and the risk of pancreatic cancer in Canada

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