Anthropometry, physical activity, and the risk of pancreatic cancer in the European prospective investigation into cancer and nutrition.
Tobacco smoking is the only established risk factor for pancreatic cancer. Results from several epidemiologic studies have suggested that increased body mass index and/or lack of physical activity may be associated with an increased risk of this disease. We examined the relationship between anthropometry and physical activity recorded at baseline and the risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition (n = 438,405 males and females age 19-84 years and followed for a total of 2,826,070 person-years). Relative risks (RR) were calculated using Cox proportional hazards models stratified by age, sex, and country and adjusted for smoking and self-reported diabetes and, where appropriate, height. In total, there were 324 incident cases of pancreatic cancer diagnosed in the cohort over an average of 6 years of follow-up. There was evidence that the RR of pancreatic cancer was associated with increased height [RR, 1.74; 95% confidence interval (95% CI), 1.20-2.52] for highest quartile compared with lowest quartile (P(trend) = 0.001). However, this trend was primarily due to a low risk in the lowest quartile, as when this group was excluded, the trend was no longer statistically significant (P = 0.27). A larger waist-to-hip ratio and waist circumference were both associated with an increased risk of developing the disease (RR per 0.1, 1.24; 95% CI, 1.04-1.48; P(trend) = 0.02 and RR per 10 cm, 1.13; 95% CI, 1.01-1.26; P(trend) = 0.03, respectively). There was a nonsignificant increased risk of pancreatic cancer with increasing body mass index (RR, 1.09; 95% CI, 0.95-1.24 per 5 kg/m(2)), and a nonsignificant decreased risk with total physical activity (RR, 0.82; 95% CI, 0.50-1.35 for most active versus inactive). Future studies should consider including measurements of waist and hip circumference, to further investigate the relationship between central adiposity and the risk of pancreatic cancer.
Berrington de González
Amy
A
Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, United Kingdom. aberring@jhsph.edu
Spencer
Elizabeth A
EA
Bueno-de-Mesquita
H Bas
HB
Roddam
Andrew
A
Stolzenberg-Solomon
Rachel
R
Halkjaer
Jytte
J
Tjønneland
Anne
A
Overvad
Kim
K
Clavel-Chapelon
Francoise
F
Boutron-Ruault
Marie-Christine
MC
Boeing
Heiner
H
Pischon
Tobias
T
Linseisen
Jakob
J
Rohrmann
Sabine
S
Trichopoulou
Antonia
A
Benetou
Vassiliki
V
Papadimitriou
Aristoteles
A
Pala
Valeria
V
Palli
Domenico
D
Panico
Salvatore
S
Tumino
Rosario
R
Vineis
Paolo
P
Boshuizen
Hendriek C
HC
Ocke
Marga C
MC
Peeters
Petra H
PH
Lund
Eiliv
E
Gonzalez
Carlos A
CA
Larrañaga
Nerea
N
Martinez-Garcia
Carmen
C
Mendez
Michelle
M
Navarro
Carmen
C
Quirós
J Ramón
JR
Tormo
María-José
MJ
Hallmans
Göran
G
Ye
Weimin
W
Bingham
Sheila A
SA
Khaw
Kay-Tee
KT
Allen
Naomi
N
Key
Tim J
TJ
Jenab
Mazda
M
Norat
Teresa
T
Ferrari
Pietro
P
Riboli
Elio
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010190:Pancreatic Neoplasms / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors