Cancer Causes & Control

, Volume 21, Issue 8, pp 1305–1314 | Cite as

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

  • 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
  • Jane A. Hoppin
  • Bu-tian Ji
  • Michael F. Leitzmann
  • Martha S. Linet
  • Cari L. Meinhold
  • Catherine Schairer
  • Arthur Schatzkin
  • Jarmo Virtamo
  • Stephanie J. Weinstein
  • Wei Zheng
  • Rachael Z. Stolzenberg-Solomon
Original paper



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.


Pancreatic 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


Confidence interval


National Cancer Institute-Division of Cancer Epidemiology and Genetics


Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial


Standard deviation


Shanghai Women’s Health Study


Relative risk


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.

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.


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Copyright information

© US Government 2010

Authors and Affiliations

  • Li Jiao
    • 1
    • 6
  • Amy Berrington de Gonzalez
    • 1
  • Patricia Hartge
    • 1
  • Ruth M. Pfeiffer
    • 1
  • Yikyung Park
    • 1
  • D. Michal Freedman
    • 1
  • Mitchell H. Gail
    • 1
  • Michael C. R. Alavanja
    • 1
  • Demetrius Albanes
    • 1
  • Laura E. Beane Freeman
    • 1
  • Wong-Ho Chow
    • 1
  • Wen-Yi Huang
    • 1
  • Richard B. Hayes
    • 1
  • Jane A. Hoppin
    • 2
  • Bu-tian Ji
    • 1
  • Michael F. Leitzmann
    • 3
  • Martha S. Linet
    • 1
  • Cari L. Meinhold
    • 1
  • Catherine Schairer
    • 1
  • Arthur Schatzkin
    • 1
  • Jarmo Virtamo
    • 4
  • Stephanie J. Weinstein
    • 1
  • Wei Zheng
    • 5
  • Rachael Z. Stolzenberg-Solomon
    • 1
  1. 1.Division of Cancer Epidemiology and GeneticsNational Cancer Institute, National Institutes of HealthBethesdaUSA
  2. 2.Epidemiology BranchNational Institute of Environmental Health Sciences, National Institutes of HealthResearch Triangle ParkUSA
  3. 3.Department of Epidemiology and Preventive MedicineRegensburg University Medical CenterRegensburgGermany
  4. 4.Department of Chronic Disease PreventionNational Institute for Health and WelfareHelsinkiFinland
  5. 5.Division of EpidemiologyVanderbilt University Medical CenterNashvilleUSA
  6. 6.Department of MedicineBaylor College of MedicineHoustonUSA

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