title: Body mass index, effect modifiers, and risk of pancreatic cancer: a pooled study of seven prospective cohorts.
abstract: OBJECTIVE
  To investigate whether the positive association of body mass index (BMI, kg/m(2)) with risk of pancreatic cancer is modified by age, sex, smoking status, physical activity, and history of diabetes.
  
  
  METHODS
  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.
  
  
  RESULTS
  In a random-effects meta-analysis, for every 5 kg/m(2) 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/m(2) 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).
  
  
  CONCLUSIONS
  The present evidence suggests that a high BMI is an independent risk factor of pancreatic cancer.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. jiao@bcm.edu
authors.forename: Li
authors.initials: L
authors.lastname: Jiao
authors.forename: Amy
authors.initials: A
authors.lastname: Berrington de Gonzalez
authors.forename: Patricia
authors.initials: P
authors.lastname: Hartge
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Pfeiffer
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.forename: D Michal
authors.initials: DM
authors.lastname: Freedman
authors.forename: Mitchell H
authors.initials: MH
authors.lastname: Gail
authors.forename: Michael C R
authors.initials: MC
authors.lastname: Alavanja
authors.forename: Demetrius
authors.initials: D
authors.lastname: Albanes
authors.forename: Laura E
authors.initials: LE
authors.lastname: Beane Freeman
authors.forename: Wong-Ho
authors.initials: WH
authors.lastname: Chow
authors.forename: Wen-Yi
authors.initials: WY
authors.lastname: Huang
authors.forename: Richard B
authors.initials: RB
authors.lastname: Hayes
authors.forename: Jane A
authors.initials: JA
authors.lastname: Hoppin
authors.forename: Bu-Tian
authors.initials: BT
authors.lastname: Ji
authors.forename: Michael F
authors.initials: MF
authors.lastname: Leitzmann
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
authors.forename: Cari L
authors.initials: CL
authors.lastname: Meinhold
authors.forename: Catherine
authors.initials: C
authors.lastname: Schairer
authors.forename: Arthur
authors.initials: A
authors.lastname: Schatzkin
authors.forename: Jarmo
authors.initials: J
authors.lastname: Virtamo
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Weinstein
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.forename: Rachael Z
authors.initials: RZ
authors.lastname: Stolzenberg-Solomon
mesh_terms: D000367:Age Factors; D015992:Body Mass Index; D015331:Cohort Studies; D015987:Effect Modifier, Epidemiologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000209:etiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors
references.citation: Cancer Causes Control. 2007 Mar;18(2):165-75
references.pmid: 17219012
references.citation: Cancer Epidemiol Biomarkers Prev. 2006 Dec;15(12):2435-40
references.pmid: 17164367
references.citation: Br J Cancer. 2003 Aug 4;89(3):519-23
references.pmid: 12888824
references.citation: JAMA. 2005 Dec 14;294(22):2872-8
references.pmid: 16352795
references.citation: Proc Nutr Soc. 2001 Feb;60(1):91-106
references.pmid: 11310428
references.citation: Cancer Causes Control. 2002 Jun;13(5):417-26
references.pmid: 12146846
references.citation: Am J Epidemiol. 2009 May 1;169(9):1043-51
references.pmid: 19299403
references.citation: Int J Cancer. 2007 Jun 15;120(12):2665-71
references.pmid: 17304505
references.citation: Control Clin Trials. 1986 Sep;7(3):177-88
references.pmid: 3802833
references.citation: Br J Cancer. 2005 Nov 28;93(11):1310-5
references.pmid: 16288300
references.citation: Cancer Epidemiol Biomarkers Prev. 2007 Oct;16(10):2101-9
references.pmid: 17905943
references.citation: Stat Med. 2002 Jun 15;21(11):1539-58
references.pmid: 12111919
references.citation: BMC Cancer. 2008 Feb 28;8:63
references.pmid: 18307811
references.citation: Cancer Res. 2009 Feb 15;69(4):1439-47
references.pmid: 19208842
references.citation: Cancer Causes Control. 2006 Sep;17(7):901-9
references.pmid: 16841257
references.citation: Diabetes Care. 1996 Nov;19(11):1229-32
references.pmid: 8908385
references.citation: Cancer Res. 1998 Jan 1;58(1):38-41
references.pmid: 9426054
references.citation: Am J Epidemiol. 2005 Dec 1;162(11):1123-31
references.pmid: 16236996
references.citation: Int J Cancer. 1996 May 16;66(4):432-7
references.pmid: 8635856
references.citation: Bull Environ Contam Toxicol. 1981 Jul;27(1):23-7
references.pmid: 7296033
references.citation: Cancer Causes Control. 2007 Jun;18(5):571-9
references.pmid: 17387622
references.citation: Obes Rev. 2007 Jul;8(4):307-26
references.pmid: 17578381
references.citation: JAMA. 2000 May 17;283(19):2552-8
references.pmid: 10815119
references.citation: Cancer Causes Control. 2009 Aug;20(6):825-34
references.pmid: 19194662
references.citation: Cancer Epidemiol Biomarkers Prev. 2005 Feb;14(2):459-66
references.pmid: 15734973
references.citation: Lancet. 2008 Feb 16;371(9612):569-78
references.pmid: 18280327
references.citation: Cancer Causes Control. 2007 Aug;18(6):603-12
references.pmid: 17401636
references.citation: Cancer Epidemiol Biomarkers Prev. 2005 Nov;14(11 Pt 1):2678; author reply 2678-9
references.pmid: 16284397
references.citation: Nat Rev Cancer. 2004 Aug;4(8):579-91
references.pmid: 15286738
references.citation: Am J Epidemiol. 2006 Jun 1;163(11):1053-64
references.pmid: 16624970
references.citation: Int J Cancer. 2007 May 1;120(9):1993-8
references.pmid: 17266034
references.citation: Nutr J. 2005 Oct 06;4:27
references.pmid: 16209706
references.citation: JAMA. 2009 Jun 24;301(24):2553-62
references.pmid: 19549972
references.citation: Am J Prev Med. 2001 May;20(4):294-8
references.pmid: 11331120
references.citation: Am J Epidemiol. 2008 Nov 1;168(9):1047-55
references.pmid: 18801887
references.citation: Int J Obes Relat Metab Disord. 2002 Sep;26(9):1159-64
references.pmid: 12187391
references.citation: Cancer Epidemiol Biomarkers Prev. 2006 Aug;15(8):1458-63
references.pmid: 16896032
references.citation: Int J Obes Relat Metab Disord. 2004 Apr;28(4):594-9
references.pmid: 14770196
references.citation: Int J Cancer. 2009 Mar 1;124(5):1206-12
references.pmid: 19058219
references.citation: JAMA. 2001 Aug 22-29;286(8):921-9
references.pmid: 11509056
references.citation: Am J Epidemiol. 2005 Aug 1;162(3):222-8
references.pmid: 15987732
references.citation: Cancer Epidemiol Biomarkers Prev. 2006 May;15(5):879-85
references.pmid: 16702364
references.citation: Am J Epidemiol. 2008 Mar 1;167(5):586-97
references.pmid: 18270373
references.citation: Br J Cancer. 2008 Aug 5;99(3):527-31
references.pmid: 18628761
references.citation: Am J Epidemiol. 2004 Feb 1;159(3):259-68
references.pmid: 14742286
references.citation: Diabetes Obes Metab. 2005 Jul;7(4):327-33
references.pmid: 15955118
references.citation: Ann Epidemiol. 1994 Jan;4(1):1-10
references.pmid: 8205268
references.citation: J Am Diet Assoc. 2001 Jan;101(1):28-34; quiz 35-6
references.pmid: 11209581
references.citation: Cancer Causes Control. 2005 Dec;16(10):1235-44
references.pmid: 16215874
references.citation: Int J Obes (Lond). 2006 May;30(5):822-9
references.pmid: 16404410
references.citation: N Engl J Med. 2003 Apr 24;348(17):1625-38
references.pmid: 12711737
references.citation: N Engl J Med. 1986 Jan 9;314(2):79-82
references.pmid: 3941694
references.citation: Cancer. 1992 Jan 15;69(2):586-98
references.pmid: 1728391