Body mass index, effect modifiers, and risk of pancreatic cancer: a pooled study of seven prospective cohorts
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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.
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.
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).
The present evidence suggests that a high BMI is an independent risk factor of pancreatic cancer.
KeywordsPancreatic cancer Body mass index Pooled analysis Prospective cohort Effect modification
National Institutes of Health-AARP Diet and Health Study
Agricultural Health Study
Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study
Breast Cancer Detection Demonstration Project
Body mass index
National Cancer Institute-Division of Cancer Epidemiology and Genetics
Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial
Shanghai Women’s Health Study
United States Radiologic Technologists Study
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.
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.
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