title: A pooled analysis of 14 cohort studies of anthropometric factors and pancreatic cancer risk.
abstract: Epidemiologic studies of pancreatic cancer risk have reported null or nonsignificant positive associations for obesity, while associations for height have been null. Waist and hip circumference have been evaluated infrequently. A pooled analysis of 14 cohort studies on 846,340 individuals was conducted; 2,135 individuals were diagnosed with pancreatic cancer during follow-up. Study-specific relative risks (RRs) and 95% confidence intervals (CIs) were calculated by Cox proportional hazards models, and then pooled using a random effects model. Compared to individuals with a body mass index (BMI) at baseline between 21-22.9 kg/m(2) , pancreatic cancer risk was 47% higher (95%CI:23-75%) among obese (BMI ≥ 30 kg/m(2) ) individuals. A positive association was observed for BMI in early adulthood (pooled multivariate [MV]RR = 1.30, 95%CI = 1.09-1.56 comparing BMI ≥ 25 kg/m(2) to a BMI between 21 and 22.9 kg/m(2) ). Compared to individuals who were not overweight in early adulthood (BMI < 25 kg/m(2) ) and not obese at baseline (BMI < 30 kg/m(2) ), pancreatic cancer risk was 54% higher (95%CI = 24-93%) for those who were overweight in early adulthood and obese at baseline. We observed a 40% higher risk among individuals who had gained BMI ≥ 10 kg/m(2) between BMI at baseline and younger ages compared to individuals whose BMI remained stable. Results were either similar or slightly stronger among never smokers. A positive association was observed between waist to hip ratio (WHR) and pancreatic cancer risk (pooled MVRR = 1.35 comparing the highest versus lowest quartile, 95%CI = 1.03-1.78). BMI and WHR were positively associated with pancreatic cancer risk. Maintaining normal body weight may offer a feasible approach to reducing morbidity and mortality from pancreatic cancer.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. jg3081@columbia.edu
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: Leslie
authors.initials: L
authors.lastname: Bernstein
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
authors.forename: Eugenia E
authors.initials: EE
authors.lastname: Calle
authors.forename: Dallas R
authors.initials: DR
authors.lastname: English
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Folsom
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: Pamela L
authors.initials: PL
authors.lastname: Horn-Ross
authors.forename: Susanna C
authors.initials: SC
authors.lastname: Larsson
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: Anthony B
authors.initials: AB
authors.lastname: Miller
authors.forename: Alpa V
authors.initials: AV
authors.lastname: Patel
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Rohan
authors.forename: Rachael Z
authors.initials: RZ
authors.lastname: Stolzenberg-Solomon
authors.forename: Bas A J
authors.initials: BA
authors.lastname: Verhage
authors.forename: Jarmo
authors.initials: J
authors.lastname: Virtamo
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Willcox
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; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D001827:Body Height; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology*; D012307:Risk Factors; D049629:Waist-Hip Ratio