Body mass index, effect modifiers, and risk of pancreatic cancer: a pooled study of seven prospective cohorts.
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.
Jiao
Li
L
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. jiao@bcm.edu
Berrington de Gonzalez
Amy
A
Hartge
Patricia
P
Pfeiffer
Ruth M
RM
Park
Yikyung
Y
Freedman
D Michal
DM
Gail
Mitchell H
MH
Alavanja
Michael C R
MC
Albanes
Demetrius
D
Beane Freeman
Laura E
LE
Chow
Wong-Ho
WH
Huang
Wen-Yi
WY
Hayes
Richard B
RB
Hoppin
Jane A
JA
Ji
Bu-Tian
BT
Leitzmann
Michael F
MF
Linet
Martha S
MS
Meinhold
Cari L
CL
Schairer
Catherine
C
Schatzkin
Arthur
A
Virtamo
Jarmo
J
Weinstein
Stephanie J
SJ
Zheng
Wei
W
Stolzenberg-Solomon
Rachael Z
RZ
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
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