Risk factors for pancreatic cancer were evaluated in a cohort study of 17,633 White men in the United States who responded to a mailed questionnaire in 1966 and were followed-up through 1986 for mortality. Cigarette smoking and alcohol consumption were found to be important risk factors for pancreatic cancer. Risks increased significantly with number of cigarettes smoked, reaching fourfold for smokers of 25 or more cigarettes per day relative to nonsmokers. Alcohol intake also was related significantly to risk, with consumers of 10 or more drinks per month having three times the risk of nondrinkers, but dose-response trends among drinkers were not smooth. Coffee consumption was unrelated to risk. Dietary analyses revealed a rising rate of pancreatic cancer mortality with increasing consumption of meat after adjustment for other risk factors. Men in the highest quartile of meat intake had about three times the risk of those in the lowest quartile. No consistent association, however, was observed for consumption of fruits, vegetables, or grains. This study confirms cigarette smoking as an important risk factor for pancreatic cancer, and provides evidence that elevated intake of alcohol and meat may increase the risk of this fatal malignancy.

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Five-year follow-up results for 8,278 men who in mail surveys had reported their cigarette smoking and dietary habits showed: (1) an index for vitamin A intake to be negatively associated with lung cancer incidence at all levels of cigarette smoking;(2) this association to be more clearly expressed in the subset of histologically proven pulmonary carcinomas other than adenocarcinoma; and (3) the positive association between cigarette smoking and lung cancer to obtain irrespective of the dietary level of vitamin A or related factors. The findings are in accordance with experimental results on animals and call for further exploration of the role of nutritional factors in the development of human lung cancer.

A previously reported negative association between a high index of dietary vitamin A and lung cancer incidence was confirmed in an extended follow-up, covering 11 1/2 years, of 13,785 men and 2,928 women, Responses to a postal questionnaire provided the dietary information. Relationships between the major dietary items and lung cancer were explored for various diagnostic subsets of the 168 lung cancer cases diagnosed among the study subjects. Analyses were stratified for sex, age, residence characteristics, cigarette smoking and, at times, socioeconomic group. Although the data do not permit a firm interpretation in terms of risk enhancement by a marginal retinoid deficiency, we found that the apparent protection afforded by higher intakes of vitamin A or its provitamins was particularly strong for lung cancer appearing as squamous-cell carcinoma and among those with higher alcohol intakes. The individual food items which showed the strongest negative association with lung cancer were carrots and milk. These two items made a major contribution to the vitamin A index and its variation among the respondents.

Summary Relationships between milk intake and cancer incidence were investigated after I 1I years of follow-up of 15,914 individuals. A diagnosis of cancer was made in a total of 1,422 individuals. No association was established with total cancer incidence, in analyses adjusted for sex, age and residential characteristics. However, a strong positive association with milk consumption was observed for cancers of the lymphatic organs (odds ratio 3.4 for > 2 glasses per day vs <1; 95% confidence interval 1. 4-8.2). An inverse association was found for cancer of the bladder. Kidney cancer and cancers of the female reproductive organs (except the uterine cervix) showed weak positive associations with milk intake.