Alcohol intake and pancreatic cancer risk: a pooled analysis of fourteen cohort studies.
BACKGROUND
Few risk factors have been implicated in pancreatic cancer etiology. Alcohol has been theorized to promote carcinogenesis. However, epidemiologic studies have reported inconsistent results relating alcohol intake to pancreatic cancer risk.


METHODS
We conducted a pooled analysis of the primary data from 14 prospective cohort studies. The study sample consisted of 862,664 individuals among whom 2,187 incident pancreatic cancer cases were identified. Study-specific relative risks and 95% confidence intervals were calculated using Cox proportional hazards models and then pooled using a random effects model.


RESULTS
A slight positive association with pancreatic cancer risk was observed for alcohol intake (pooled multivariate relative risk, 1.22; 95% confidence interval, 1.03-1.45 comparing >or=30 to 0 grams/day of alcohol; P value, test for between-studies heterogeneity=0.80). For this comparison, the positive association was only statistically significant among women although the difference in the results by gender was not statistically significant (P value, test for interaction=0.19). Slightly stronger results for alcohol intake were observed when we limited the analysis to cases with adenocarcinomas of the pancreas. No statistically significant associations were observed for alcohol from wine, beer, and spirits comparing intakes of >or=5 to 0 grams/day. A stronger positive association between alcohol consumption and pancreatic cancer risk was observed among normal weight individuals compared with overweight and obese individuals (P value, test for interaction=0.01).


CONCLUSIONS
Our findings are consistent with a modest increase in risk of pancreatic cancer with consumption of 30 or more grams of alcohol per day.
Genkinger
Jeanine M
JM
Department of Oncology, Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
Spiegelman
Donna
D
Anderson
Kristin E
KE
Bergkvist
Leif
L
Bernstein
Leslie
L
van den Brandt
Piet A
PA
English
Dallas R
DR
Freudenheim
Jo L
JL
Fuchs
Charles S
CS
Giles
Graham G
GG
Giovannucci
Edward
E
Hankinson
Susan E
SE
Horn-Ross
Pamela L
PL
Leitzmann
Michael
M
Männistö
Satu
S
Marshall
James R
JR
McCullough
Marjorie L
ML
Miller
Anthony B
AB
Reding
Douglas J
DJ
Robien
Kim
K
Rohan
Thomas E
TE
Schatzkin
Arthur
A
Stevens
Victoria L
VL
Stolzenberg-Solomon
Rachael Z
RZ
Verhage
Bas A J
BA
Wolk
Alicja
A
Ziegler
Regina G
RG
Smith-Warner
Stephanie A
SA
D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000209:etiology*; D016016:Proportional Hazards Models; D012307:Risk Factors