Physical activity, body weight, and pancreatic cancer mortality

Lee, I. M.; Sesso, Howard D.; Oguma, Yuko; Paffenbarger, Ralph S.

doi:10.1038/sj.bjc.6600782

Cited by 65 publications

(36 citation statements)

References 26 publications

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“…Since 2000, at least 13 prospective cohort studies carried out in Western countries have reported a link between BMI and pancreatic cancer risk, 6,10,[15][16][17][18][19][20][21][22]26,35 although the findings have been inconsistent. In studies carried out in the U.S.A., a positive relationship was demonstrated for both men and women in the 3 largest cohort studies, [15][16][17] while 4 other smaller studies found a positive association only in men.…”

Section: Discussionmentioning

confidence: 93%

“…In studies carried out in the U.S.A., a positive relationship was demonstrated for both men and women in the 3 largest cohort studies, [15][16][17] while 4 other smaller studies found a positive association only in men. 10,22,26,33 The 6 other studies, including the 2 largest European cohort studies, 6,[18][19][20][21]35 did not find any significant association in the combined data of men and women. Similar to cohort studies, case-control studies have also produced contradictory results with a meta-analysis carried out in 2003 concluding that the risk of pancreatic cancer was only weakly associated with obesity.…”

Section: Discussionmentioning

confidence: 99%

“…Several large prospective studies carried out in the U.S.A. have demonstrated that overweight and obese subjects have an increased risk of pancreatic cancer compared with normal weight subjects, [15][16][17] whereas other studies did not observe this association. [18][19][20][21] A meta-analysis conducted in 2003 showed a small positive increase in the risk of pancreatic cancer per unit increase in body mass index (BMI). 36 However, the 14 studies included in this meta-analysis were all carried out in Western countries.…”

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confidence: 99%

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Obesity, physical activity and the risk of pancreatic cancer in a large Japanese cohort

Lin

Kikuchi

Tamakoshi

et al. 2007

Intl Journal of Cancer

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It is unclear whether body mass index (BMI) and physical activity are associated with the risk of pancreatic cancer in Asian populations. We examined these associations in the Japanese Collaborative Cohort Study for Evaluation of Cancer Risk. Our cohort study included 110,792 Japanese men and women at enrollment (1988)(1989)(1990). Data on height, body weight (at baseline and at age 20 years) and physical activity were obtained from a questionnaire. Cox proportional hazards models were used to estimate the relative risks of pancreatic cancer mortality. We observed a total of 402 pancreatic cancer deaths during the follow-up period. Men with a BMI of 30 or more at age 20 years had a 3.5-fold greater risk compared with men with a normal BMI. Women with a BMI of 27.5-29.9 at baseline had 60% increased risk compared with women with a BMI of 20.0-22.4. In men, weight loss of 5 kg or more between 20 years of age and baseline age was associated with an increased risk of pancreatic cancer death. In contrast, women with weight loss of 5 kg or more over the same period had a decreased risk. Physical activity was not associated with pancreatic cancer risk in either men or women. Obesity in young adulthood may be associated with an increased risk of death from pancreatic cancer in Japanese men. The risk of pancreatic cancer in relation to BMI seems to differ according to sex and the period over which BMI was measured. ' 2007 Wiley-Liss, Inc.Key words: body mass index; physical activity; pancreatic cancer; obesity; relative risk; cohort study Pancreatic cancer is the fifth leading cause of cancer-related death in Japan, accounting for 20,000 deaths each year. 1 The etiology of pancreatic cancer remains largely unknown. Although epidemiological studies have reported that many environmental factors may contribute to the development of pancreatic cancer, only age and cigarette smoking have been established as consistent risk factors for the disease. 2 The association between diabetes and pancreatic cancer is less consistent, although epidemiological evidence strongly suggests that long-standing diabetes is also a risk factor for pancreatic cancer. [3][4][5][6][7][8][9] Recently, several studies have shown a positive association between post-load plasma glucose concentration and pancreatic cancer risk, [10][11][12] suggesting that impaired glucose tolerance and insulin resistance may have a role in the etiology of pancreatic cancer. As there is an established link between obesity and significant metabolic abnormalities such as glucose intolerance, 13,14 a positive association between obesity and pancreatic cancer seems possible. However, there are conflicting epidemiological findings on the link between obesity and risk of pancreatic cancer. Several large prospective studies carried out in the U.S.A. have demonstrated that overweight and obese subjects have an increased risk of pancreatic cancer compared with normal weight subjects, 15-17 whereas other studies did not observe this association. [18][19][20][21] A meta-analysis c...

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Obesity, physical activity and the risk of pancreatic cancer in a large Japanese cohort

Lin

Kikuchi

Tamakoshi

et al. 2007

Intl Journal of Cancer

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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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“…However, study done by Ghorbani Z et al [29] have shown in a well-matched case control study that increased frequency of intake of rice, bread and barbequed meat and deep fried vegetables can aggregate the risk while consumption of fish can decrease the incidence of pancreatic cancer. There has been no association between intake of fat and risk of pancreatic cancer [30] while exercise, which helps to maintain normal body weight, has been associated with a reduced risk of pancreatic cancer [31]. Non-steroidal anti-inflammatory drugs (NSAIDs), mainly aspirin, have shown to decrease risk of pancreatic cancer [32,33]; however, other non-aspirin NSAIDs have not shown the benefit [34].…”

Section: Dietmentioning

confidence: 99%

Epidemiology of Pancreatic and Periampullary Cancer

Thapa

2015

Indian J Surg

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Pancreatic cancer is an important public health problem, although infrequent but with an exceptionally high mortality rate worldwide. Given that the majority of cancers occur in association with smoking, diabetes, pancreatitis, genetic factors, and others and with a growing population worldwide in mind, more cases would be expected in the near future giving further impetus to investigating prevention and treatment strategies to this international issue. The representative data on epidemiology of carcinoma of pancreas in India and Nepal are very poor. While there are many questions to be resolved, it is apparent that many facets of pancreatic cancer are becoming increasingly understood, and prospects for prevention are becoming apparent. Hence, screening research, recommendations, and implementation is an obvious priority. Although previous studies have contributed to the knowledge of carcinoma of pancreas epidemiology, such association needs to be further verified with proper epidemiological work. A new and global approach to the study of carcinoma of pancreas epidemiology is required if the disease prevention and treatment strategies are to be adequately directed and supported in the coming years. The collection and analysis of epidemiologic carcinoma of pancreas data will play a critical role in guiding future disease prevention strategies and optimizing patient management.

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Physical activity, body weight, and pancreatic cancer mortality

Cited by 65 publications

References 26 publications

Obesity, physical activity and the risk of pancreatic cancer in a large Japanese cohort

Obesity, physical activity and the risk of pancreatic cancer in a large Japanese cohort

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

Epidemiology of Pancreatic and Periampullary Cancer

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