title: Association of cholesterol with risk of pancreatic cancer: a meta-analysis.
abstract: OBJECTIVE
  To evaluate the effect of dietary cholesterol and serum total cholesterol (TC) on the risk of pancreatic cancer.
  
  
  METHODS
  A literature search was performed up to June 2014 in PubMed, EMBASE, China National Knowledge Infrastructure and China Biology Medical literature database for relevant articles published in English or Chinese. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated with a random-effects model.
  
  
  RESULTS
  We included 14 published articles with 439355 participants for dietary cholesterol, and 6 published articles with 1805697 participants for serum TC. For the highest vs lowest category of dietary cholesterol, the pooled RR (95%CI) of pancreatic cancer was 1.308 (1.097-1.559). After excluding two studies (RR > 3.0), the pooled RR (95%CI) was 1.204 (1.050-1.380). In subgroup analysis stratified by study design, the pooled RRs (95%CIs) were 1.523 (1.226-1.893) for case-control studies and 1.023 (0.871-1.200) for cohort studies. The association of dietary cholesterol with the risk of pancreatic cancer was significant for studies conducted in North America [1.275 (1.058-1.537)] and others [2.495 (1.565-3.977)], but not in Europe [1.149 (0.863-1.531)]. No significant association [1.003 (0.859-1.171)] was found between the risk of pancreatic cancer and serum TC.
  
  
  CONCLUSIONS
  Dietary cholesterol may be associated with an increased risk of pancreatic cancer in worldwide populations, except for Europeans. The results need to be confirmed further.
authors.affiliation: Jia Wang, Wei-Jing Wang, Long Zhai, Dong-Feng Zhang, Department of Epidemiology and Health Statistics, Qingdao University Medical College, Qingdao 266021, Shandong Province, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Wang
authors.affiliation: Jia Wang, Wei-Jing Wang, Long Zhai, Dong-Feng Zhang, Department of Epidemiology and Health Statistics, Qingdao University Medical College, Qingdao 266021, Shandong Province, China.
authors.forename: Wei-Jing
authors.initials: WJ
authors.lastname: Wang
authors.affiliation: Jia Wang, Wei-Jing Wang, Long Zhai, Dong-Feng Zhang, Department of Epidemiology and Health Statistics, Qingdao University Medical College, Qingdao 266021, Shandong Province, China.
authors.forename: Long
authors.initials: L
authors.lastname: Zhai
authors.affiliation: Jia Wang, Wei-Jing Wang, Long Zhai, Dong-Feng Zhang, Department of Epidemiology and Health Statistics, Qingdao University Medical College, Qingdao 266021, Shandong Province, China.
authors.forename: Dong-Feng
authors.initials: DF
authors.lastname: Zhang
mesh_terms: D000368:Aged; D002791:Cholesterol, Dietary / Q000009:adverse effects* / Q000097:blood; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000175:diagnosis / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010190:Pancreatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000208:ethnology*; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D002791:Cholesterol, Dietary
keywords: Dietary cholesterol; Meta-analysis; Pancreatic cancer; Risk; Serum total cholesterol
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