Anthropometric Measures, Body Mass Index, and Pancreatic Cancer

Abstract

Background Pooled data were analyzed from the NCI Pancreatic Cancer Cohort Consortium (PanScan) to study the association between pre-diagnostic anthropometric measures and risk of pancreatic cancer. Methods PanScan applied a nested case-control study design and included 2,170 cases and 2,209 controls. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression for cohort-specific quartiles of body mass index (BMI), weight, height, waist circumference, and waist-to-hip ratio (WHR), as well as conventional BMI categories: underweight (<18.5 kg/m2), normal (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), obese (30.0-34.9 kg/m2), and severely obese (≥35.0 kg/m2). Models were adjusted for potential confounders. Results Among all subjects, a positive association between increasing BMI and risk of pancreatic cancer was observed (adjusted OR for the highest vs. lowest BMI quartile = 1.33, 95% CI = 1.12-1.58, Ptrend < 0.001). Among men, the adjusted OR for pancreatic cancer for the highest vs. lowest quartile of BMI was 1.33 (95% CI = 1.04-1.69, Ptrend <0.03). Among women, the adjusted OR for pancreatic cancer for the highest quartile of BMI was 1.34 (95% CI = 1.05-1.70, Ptrend = 0.01). Increased WHR was associated with increased risk of pancreatic cancer among women (adjusted OR for the highest vs. lowest quartile = 1.87, 95% CI = 1.31-2.69, Ptrend = 0.003) but less so in men. Conclusion The findings provide strong support for a positive association between BMI and pancreatic cancer risk. In addition, centralized fat distribution may increase pancreatic cancer risk, especially in women.

Epidemiology of Pancreatic Cancer: An Update

“…This last study also found that centralized fat distribution may increase pancreatic cancer risk, especially in women [49] . Another recent study found that overweight or obesity during early adulthood was associated with a greater risk of pancreatic cancer and a younger age of disease onset (2-6 years earlier than the average age of onset of pancreatic cancer) [50] .…”

“…In a subsequent pooled analysis of data from 13 prospective cohort studies as part of the PANSCAN consortium, overweight and obesity were significantly associated with a 20% excess risk of pancreatic cancer [49] . This last study also found that centralized fat distribution may increase pancreatic cancer risk, especially in women [49] .…”

Hormonal factors and pancreatic cancer risk in women: The Malmö Diet and Cancer Study

“…As mentioned, several studies present results showing an increased risk of pancreatic cancer with increasing BMI,13, 21, 22, 23 which has not been observed in the MDCS, neither in men nor in women 42. Still, adipose tissue is also known to produce estrogens, thus suggesting it may play a protective role as well.…”

“…Tobacco smoking,4, 5, 6 high age4, 7, 8 and heredity9, 10 seem to be the only truly validated risk factors for pancreatic cancer. Several other risk factors have been investigated, and numerous studies claim a significant impact of diabetes,11, 12, 13 pancreatitis,14, 15, 16 alcohol17, 18, 19, 20 and body mass index (BMI)13, 21, 22, 23; however, no consensus has yet been reached.…”

Adipose Triglyceride Lipase (ATGL) Expression Is Associated with Adiposity and Tumor Stromal Proliferation in Patients with Pancreatic Ductal Adenocarcinoma

“…In a large casecontrol study, Silverman et al (6) showed obesity portends a 50-60% increased risk of PDAC in both men and women. Similarly, a pooled case-control analysis using data from the Pancreatic Cancer Cohort Consortium (PanScan) comparing 2170 PDAC cases to 2209 controls showed a positive association between increasing body mass index (BMI) and risk of PDAC [adjusted odds ratio (aOR) for the highest vs. lowest BMI quartile=1.33, 95% confidence interval (CI)= 1.12-1.58, p<0.001 (7).…”