Underweight, overweight, and obese men and women had higher rates of death than men and women of normal weight. The association of BMI with death varied according to the cause of death and was modified by age, sex, and smoking history.

Pancreatic cancer is one of the most fatal human cancers and continues to be a major unsolved health problem. The goal of this study was to estimate the independent effects and interactions between cigarette smoking and diabetes on the risk of pancreatic cancer in Korean male population. Cigarette smoking and the risk of incidence and death from pancreatic cancer were examined in a 10-year prospective cohort study of 446,407 Korean men aged 40 to 65 years who received health insurance from the National Health Insurance Corporation and who had a medical evaluation in 1992. Relative risks (RR) and 95% confidence intervals (CI) were calculated using a Cox proportional hazards model after adjusting for age, body mass index, exercise and alcohol use. Current smoking was associated with an increased risk of incidence (RR 5 1.7, 95% CI 5 1.6-1.9) and mortality (RR 5 1.6, 95% CI 5 1.4-1.7) from pancreatic cancer. The RR for pancreatic cancer increased with both duration and amount of smoking. Diabetes was also associated with an increased risk of both incidence (RR 5 1.8, 95% CI 5 1.5-2.2) and mortality (RR 5 1.7, 95% CI 5 1.4-2.1) from pancreatic cancer. There was no interaction between smoking and fasting serum glucose in terms of pancreatic cancer risk. Thus, our prospective study has demonstrated that cigarette smoking and elevated fasting serum glucose are independently associated with an increased risk of pancreatic cancer in a large cohort of Korean males. ' 2006 Wiley-Liss, Inc.Key words: pancreatic cancer; smoking; fasting serum glucose; diabetes; cohort study Pancreatic cancer remains a major unsolved health problem at the start of the 21st century. Although cancer of the pancreas accounts for only 3% of all cancers worldwide, 1 its poor prognosis makes it the eighth major form of cancer-related death worldwide, causing more than 220,000 deaths annually. 2 Because of the poor prognosis and the minimal impact of conventional treatment methods, 3 it is important to focus on prevention of this disease. In many previous studies, risk factors associated with pancreatic cancer have been explored. Risk factors for pancreatic cancer are thought to include obesity, 4-7 nutritional factors, [8][9][10][11][12][13][14][15][16] alcohol drinking, 17-23 genetic factors 24,25 and a family history 3 of pancreatic cancer. However, the major risk factors that have been consistently reported are age, diabetes 26-29 and cigarette smoking. 30 Epidemiological studies from European countries and the United States have consistently shown that cigarette smoking is associated with an increased risk of pancreatic cancer, but the dose-response relationship has not been clear due to inconsistent findings among these studies. [18][19][20][21][22][23][31][32][33][34][35][36][37][38][39][40][41][42] In addition, recent observational studies have provided consistent evidence for an association of diabetes with increased risk of pancreatic cancer. [27][28][29] To date, however, very few studies have analyzed the potential interaction between s...

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