title: A pooled analysis of body mass index and pancreatic cancer mortality in african americans.
abstract: BACKGROUND
  Pancreatic cancer is a leading cause of cancer-related mortality in the United States and both incidence and mortality are highest in African Americans. Obesity is also disproportionately high in African Americans, but limited data are available on the relation of obesity to pancreatic cancer in this population.
  
  
  METHODS
  Seven large prospective cohort studies pooled data from African American participants. Body mass index (BMI) was calculated from self-reported height and weight at baseline. Cox regression was used to calculate HRs and 95% confidence intervals (CI) for levels of BMI relative to BMI 18.5-24.9, with adjustment for covariates. Primary analyses were restricted to participants with ≥5 years of follow-up because weight loss before diagnosis may have influenced baseline BMI in cases who died during early follow-up.
  
  
  RESULTS
  In follow-up of 239,597 participants, 897 pancreatic cancer deaths occurred. HRs were 1.08 (95% CI, 0.90-1.31) for BMI 25.0 to 29.9, 1.25 (95% CI, 0.99-1.57) for BMI 30.0 to 34.9, and 1.31 (95% CI, 0.97-1.77) for BMI ≥35.0 among those with ≥5 years of follow-up (Ptrend = 0.03). The association was evident among both sexes and was independent of a history of diabetes. A stronger association was observed among never-smokers (BMI ≥30 vs. referent: HR = 1.44; 95% CI, 1.02-2.03) than among smokers (HR = 1.16; 95% CI, 0.87-1.54; Pinteraction = 0.02).
  
  
  CONCLUSIONS
  The findings suggest that obesity is independently associated with increased pancreatic cancer mortality in African Americans.
  
  
  CONCLUSIONS
  Interventions to reduce obesity may also reduce risk of pancreatic cancer mortality, particularly among never-smokers.
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, Massachusetts. tnb@bu.edu.
authors.forename: Traci N
authors.initials: TN
authors.lastname: Bethea
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
authors.forename: Cari M
authors.initials: CM
authors.lastname: Kitahara
authors.affiliation: International Epidemiology Institute, Rockville, Maryland.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sonderman
authors.affiliation: American Cancer Society, Atlanta, Georgia.
authors.forename: Alpa V
authors.initials: AV
authors.lastname: Patel
authors.affiliation: Epidemiology and Genomics Research Program, National Cancer Institute, Rockville, Maryland.
authors.forename: Chinonye
authors.initials: C
authors.lastname: Harvey
authors.affiliation: Loma Linda University, Loma Linda, California.
authors.forename: Synnøve F
authors.initials: SF
authors.lastname: Knutsen
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.affiliation: University of Hawaii Cancer Center, Honolulu, Hawaii.
authors.forename: Song Yi
authors.initials: SY
authors.lastname: Park
authors.affiliation: Loma Linda University, Loma Linda, California.
authors.forename: Gary E
authors.initials: GE
authors.lastname: Fraser
authors.affiliation: American Cancer Society, Atlanta, Georgia.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Jacobs
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Purdue
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
authors.forename: Rachael Z
authors.initials: RZ
authors.lastname: Stolzenberg-Solomon
authors.affiliation: Epidemiology and Genomics Research Program, National Cancer Institute, Rockville, Maryland.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Gillanders
authors.affiliation: International Epidemiology Institute, Rockville, Maryland. Vanderbilt University School of Medicine, Nashville, Tennessee.
authors.forename: William J
authors.initials: WJ
authors.lastname: Blot
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, Massachusetts.
authors.forename: Julie R
authors.initials: JR
authors.lastname: Palmer
authors.affiliation: University of Hawaii Cancer Center, Honolulu, Hawaii.
authors.forename: Laurence N
authors.initials: LN
authors.lastname: Kolonel
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology*; D010190:Pancreatic Neoplasms / Q000401:mortality*; D016016:Proportional Hazards Models; D055815:Young Adult