Healthy lifestyle and the risk of pancreatic cancer in the EPIC study

Abstract

Background. Pancreatic cancer (PC) is a highly fatal cancer with currently limited opportunities for early detection and effective treatment. Modifiable factors may offer pathways for primary prevention. In this study, the association between the healthy lifestyle index (HLI) and PC risk was examined. Methods. Within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, 1,113 incident PC (57% women) were diagnosed from 400,577 cancer-free participants followed-up for 15 years (median). HLI scores combined smoking, alcohol intake, dietary exposure, physical activity and, in turn, overall and central adiposity using BMI (HLIBMI) and waist-to-hip ratio (WHR, HLIWHR), respectively. High values of HLI indicate adherence to healthy behaviors. Cox proportional hazard models with age as primary time variable were used to estimate PC hazard ratios (HR) and 95% confidence intervals (CI). Sensitivity analyses were performed by excluding, in turn, each factor from the HLI score. Population attributable fractions (PAF) were estimated assuming participants' shift to healthier lifestyles. Results. The HRs for a one-standard deviation increment of HLIBMI and HLIWHR were 0.84

Multidisciplinary standards of care and recent progress in pancreatic ductal adenocarcinoma

“… 11,63‐74 How do we enable early detection in individuals with no apparent clinical risk factor such as cysts or family history? One can certainly implement public health approaches such as smoking avoidance and cessation and maintaining a healthy body mass index, because both of these modestly (approximately 1.5‐fold to 2‐fold) increase the lifetime risk of PDAC 75 . The use of genome‐wide association studies, in which thousands of polymorphisms across the genome are compared in cases versus controls, has enabled the identification of multiple susceptibility alleles in PDAC, such as alleles within the ABO blood group genes and the gene‐encoding telomerase reverse transcriptase ( TERT ) 76,77 .…”

Visceral Adiposity and Cancer: Role in Pathogenesis and Prognosis

“…Since it is undoubtedly clear that obesity is one modifiable risk factor for tumorigenesis, lifestyle interventions addressed to reduce adiposity, including dietary changes and physical activity, play a pivotal role in cancer prevention [160]. For instance, pancreatic cancer risk was inversely associated with a healthy lifestyle assessed considering diet quality, physical activity, smoking status, alcohol consumption and anthropometry [161].…”

Systematic Review of the Integrative Medicine Recommendations for Patients with Pancreatic Cancer

“…Once a patient has pancreatic adenocarcinoma, there does not seem to be a benefit to having a lower BMI, yet patients with a history of obesity do have a protective effect against developing pancreatic cancer after bariatric surgery [16,17]. In the European Prospective Investigation into Cancer and Nutrition (EPIC) trial where over 1100 patients were followed for 15 years, a healthy lifestyle was also found to have a protective effect against pancreatic cancer incidence [18]. Perhaps most compelling was the finding that a history of physical inactivity prior to being diagnosed with pancreatic adenocarcinoma was associated with an increased mortality rate and that obesity seems to confer a higher rate of chemotherapy resistance [19,20].…”