Measured body mass index in adolescence and the incidence of pancreatic cancer in a cohort of 720,000 Jewish men
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The increasing prevalence of adolescent obesity affects adult health. We investigated the association of adolescent overweight with pancreatic cancer incidence in a cohort of 720,927 Jewish Israeli men.
Body mass index (BMI) was measured during a general health examination at ages 16–19 between the years 1967 and 1995. Overweight was defined as BMI ≥ 85th percentile of the reference US-CDC distribution in adolescence. Pancreatic cancer was identified by linkage with the Israel National Cancer Registry up to 2006.
The mean follow-up period was 23.3 ± 8.0 years. During 16.8 million person-years, 98 cases of pancreatic cancer were detected. Using Cox proportional hazards modeling, overweight in adolescence predicted an increased risk of pancreatic cancer [hazard ratio (HR) = 2.09; 95% confidence interval (CI): 1.26–3.50, p = 0.005]. Compared with adolescents with ‘normal’ range BMI Z-scores (−1 to +1), adolescents with Z-scores > 1 showed significantly increased risk [HR, 2.28 (95% CI: 1.43–3.64), p = 0.001]. Lower education level (10 or less years of schooling vs. 11–12 years) was also associated with increased risk of pancreatic cancer [HR 1.90 (95% CI: 1.27–2.86, p = 0.002)], whereas height, country of origin and immigration status were not.
Adolescent overweight is substantially associated with pancreatic cancer incidence in young to middle-aged adults. Applying our point estimates to the 16.8% prevalence of excess weight in Israeli adolescents in the past decade suggests a population fraction of 15.5% (95% CI: 4.2–29.6%) for pancreatic cancer attributable to adolescent overweight in Israel.
KeywordsAdolescence Obesity Pancreatic cancer
Body mass index
United States Center for Disease Control
This study was supported by the Israel Cancer Research Fund.
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