Abstract Epidemiological studies report positive associations between high-temperature cooked meat intake and pancreatic cancer. We assessed the association between dietary intake of heterocyclic amines (HCAs) and benzo(a)pyrene (BaP)_mutagens formed in meat cooked at high temperatures_and incident exocrine pancreatic cancer in a prospective cohort. Methods: The 62,581 subjects randomized to screening in the multi-center Prostate, Lung, Colorectal and Ovarian Screening Trial (PLCO) who completed a dietary survey at study entry, which assessed meat intake, cooking methods, and doneness preferences defined the cohort. Subjects were surveyed annually for incident cancers through 2007; information was also obtained from physicians, next-of-kin, state registries, and national mortality data. A National Cancer Institute research database (CHARRED) was used to estimate intake of HCA, BaP, and mutagenic activity (Mutagenic Activity Index) from the dietary survey data. The proportional hazard ratios (HRs) for risk of pancreatic cancer were estimated from multivariate-adjusted survival analyses. Results: During follow-up (median: 10 yrs), 248 cases of exocrine pancreatic cancer were confirmed. Intake of well- and very-well done meat was generally associated with increased risks. For example, intake of very well done steak yielded an HR (95% confidence interval) of 1.43 (0.80, 2.56). Using estimated mutagen intake, significant elevations in the risk of pancreatic cancer were found in the upper quintiles of the Mutagenic Activity Index, with HRs of 1.81 (1.16, 2.83) and 1.87 (1.16, 3.02) for quintiles 4 and 5, respectively, relative to the lowest quintile. Significantly increased risks were also associated with exposure high levels of two specific mutagens: 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (DiMeIQx) and 2-amino-3,8-dimethylimidazo [4,5-f]quinoxaline (MeIQx). The HRs for DiMeIQx for quintiles 4 and 5 were 1.31 (0.86, 1.98) and 1.81 (1.20, 2.74), respectively, while those for MeIQx were 1.34 (0.87, 2.06) and 1.75 (1.11, 2.76). All three of these exposures exhibited significant positive trends in risk as their intake increased (P for linear trend: 0.01-0.03). Conclusion: Additional follow-up of this cohort has provided stronger evidence that consumption of well-done meat with elevated mutagen levels from high temperature cooking confers an increased risk of pancreatic cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1907. doi:10.1158/1538-7445.AM2011-1907
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