Abstract
Obesity and physical activity, in part through their effects on insulin sensitivity, may be modifiable risk factors for pancreatic cancer. The authors analyzed data from the American Cancer Society Cancer Prevention Study II Nutrition Cohort to examine the association between measures of adiposity, recreational physical activity, and pancreatic cancer risk. Information on current weight and weight at age 18, location of weight gain, and recreational physical activity were obtained at baseline in 1992 via a self-administered questionnaire for 145,627 men and women who were cancer-free at enrollment. During the 7 years of follow-up, 242 incident pancreatic cancer cases were identified among these participants. Cox proportional hazards modeling was used to compute hazard rate ratios (RR) and to adjust for potential confounding factors including personal history of diabetes and smoking. We observed an increased risk of pancreatic cancer among obese [body mass index (BMI) >/= 30] men and women compared with men and women of normal BMI [<25; RR, 2.08; 95% confidence interval (95% CI), 1.48-2.93, P(trend) = 0.0001]. After adjustment for between BMI, risk of pancreatic cancer was independently increased among men and women who reported a tendency for central weight gain compared with men and women reporting a tendency for peripheral weight gain (RR, 1.45; 95% CI, 1.02-2.07). We observed no difference in pancreatic cancer incidence rates between men and women who were most active (>31.5 metabolic equivalent hours per week) at baseline compared with men and women who reported no recreational physical activity (RR, 1.20; 95% CI, 0.63-2.27). This study, along with several recent studies, supports the hypothesis that obesity and central adiposity are associated with pancreatic cancer risk.
Highlights
Pancreatic cancer is the fourth leading cancer cause of death among U.S men and women [1]
We examined the association of body mass index (BMI), weight gain, location of weight gain, recreational physical activity, and risk of pancreatic cancer among men and women in the American Cancer Society Cancer Prevention Study II (CPS-II) Nutrition Cohort, a large prospective study in the United States
Active participants at all levels of metabolic equivalent (MET) expenditure engaged primarily in activities judged to be of low intensity rather than activities judged to be of moderate/high intensity
Summary
Pancreatic cancer is the fourth leading cancer cause of death among U.S men and women [1]. Cigarette smoking and diabetes are the only risk factors that have been consistently associated with pancreatic cancer [2,3,4,5,6]. Insulin resistance and abnormal glucose metabolism, without a diagnosis of diabetes, may be risk factors in pancreatic cancer etiology [7,8,9]. We hypothesized that obesity, through BMI and abdominal weight gain, and physical activity may be modifiable risk factors for pancreatic cancer. In part through their effects on insulin sensitivity, may be modifiable risk factors for pancreatic cancer. Information on current weight and weight at age 18, location of weight gain, and recreational physical activity were obtained at baseline in 1992 via a selfadministered questionnaire for 145,627 men and women who were cancer-free at enrollment. Cox proportional hazards modeling was used to compute hazard rate ratios (RR) and to adjust for potential confounding factors including personal history of diabetes and smoking
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