title: Alcohol intake and pancreatic cancer risk: a pooled analysis of fourteen cohort studies.
abstract: 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.
authors.affiliation: Department of Oncology, Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
authors.forename: Jeanine M
authors.initials: JM
authors.lastname: Genkinger
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: Kristin E
authors.initials: KE
authors.lastname: Anderson
authors.forename: Leif
authors.initials: L
authors.lastname: Bergkvist
authors.forename: Leslie
authors.initials: L
authors.lastname: Bernstein
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
authors.forename: Dallas R
authors.initials: DR
authors.lastname: English
authors.forename: Jo L
authors.initials: JL
authors.lastname: Freudenheim
authors.forename: Charles S
authors.initials: CS
authors.lastname: Fuchs
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
authors.forename: Edward
authors.initials: E
authors.lastname: Giovannucci
authors.forename: Susan E
authors.initials: SE
authors.lastname: Hankinson
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Horn-Ross
authors.forename: Michael
authors.initials: M
authors.lastname: Leitzmann
authors.forename: Satu
authors.initials: S
authors.lastname: Männistö
authors.forename: James R
authors.initials: JR
authors.lastname: Marshall
authors.forename: Marjorie L
authors.initials: ML
authors.lastname: McCullough
authors.forename: Anthony B
authors.initials: AB
authors.lastname: Miller
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Reding
authors.forename: Kim
authors.initials: K
authors.lastname: Robien
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Rohan
authors.forename: Arthur
authors.initials: A
authors.lastname: Schatzkin
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Stevens
authors.forename: Rachael Z
authors.initials: RZ
authors.lastname: Stolzenberg-Solomon
authors.forename: Bas A J
authors.initials: BA
authors.lastname: Verhage
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
authors.forename: Regina G
authors.initials: RG
authors.lastname: Ziegler
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Smith-Warner
mesh_terms: 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