Body mass index and body size in early adulthood and risk of pancreatic cancer in a central European multicenter case–control study

The relationship between two measures of excess body weight, body mass index (BMI) and body size score, and risk of pancreatic cancer was examined among 574 pancreatic cancer cases and 596 frequency‐matched controls from the Czech Republic and Slovakia enrolled between 2004 and 2009. Analyses using multivariable logistic regression showed an increased risk of pancreatic cancer associated with elevated quartiles of BMI at ages 20 [fourth quartile: odds ratio (OR) = 1.79, 95% confidence interval (CI): 1.23, 2.61] and 40 (fourth quartile: OR = 1.57, 95% CI: 1.09, 2.27) compared to the lowest quartile. Consistent results were observed for body size score at ages 20 (high versus low: OR = 1.66, 95% CI: 1.08, 2.57) and 40 (medium versus low: OR = 1.36, 95% CI: 1.00, 1.86), but no association was found for BMI and body size score at 2 years before the interview. Stronger risk estimates for BMI were observed in males than females, particularly at age 20, but the analysis of body size yielded similar estimates by sex. When considering excess body weight at both ages 20 and 40 jointly, the highest risk estimates were observed among subjects with elevated levels at both time periods in the analysis of BMI (OR = 1.86, 95% CI: 1.32, 2.62) and body size (OR = 1.53, 95% CI: 1.09, 2.13). These findings, based on two different measures, provide strong support for an increased risk of pancreatic cancer associated with excess body weight, possibly strongest during early adulthood.

[1]  Reza Malekzadeh,et al.  Pictogram use was validated for estimating individual's body mass index. , 2010, Journal of clinical epidemiology.

[2]  Wei Zheng,et al.  Anthropometric measures, body mass index, and pancreatic cancer: a pooled analysis from the Pancreatic Cancer Cohort Consortium (PanScan). , 2010, Archives of internal medicine.

[3]  V. Montori,et al.  Diagnostic performance of body mass index to identify obesity as defined by body adiposity: a systematic review and meta-analysis , 2010, International Journal of Obesity.

[4]  T. Pischon Commentary: Use of the body mass index to assess the risk of health outcomes: time to say goodbye? , 2010, International journal of epidemiology.

[5]  P. Horn,et al.  Childhood predictors of adult type 2 diabetes at 9- and 26-year follow-ups. , 2010, Archives of pediatrics & adolescent medicine.

[6]  W. Willett,et al.  Body fatness at young ages and risk of breast cancer throughout life. , 2008, American journal of epidemiology.

[7]  Pasquale Strazzullo,et al.  Childhood obesity, other cardiovascular risk factors, and premature death. , 2010, The New England journal of medicine.

[8]  Patrick Maisonneuve,et al.  Epidemiology of pancreatic cancer: an overview , 2009, Nature Reviews Gastroenterology &Hepatology.

[9]  Jeffrey S. Morris,et al.  Body Mass Index and Risk , Age of Onset , and Survival in Patients With Pancreatic Cancer , 2009 .

[10]  G. Petersen,et al.  Overweight, obesity, and pancreatic cancer: beyond risk alone. , 2009, JAMA.

[11]  V. Beral,et al.  Factors associated with incident and fatal pancreatic cancer in a cohort of middle‐aged women , 2009, International journal of cancer.

[12]  Arnold Knijn,et al.  EUROCARE-4. Survival of cancer patients diagnosed in 1995-1999. Results and commentary. , 2009, European journal of cancer.

[13]  S. Gallinger,et al.  Lifestyle, dietary, and medical history factors associated with pancreatic cancer risk in Ontario, Canada , 2009, Cancer Causes & Control.

[14]  H. Friess,et al.  Pancreatic cancerrelated cachexia: influence on metabolism and correlation to weight loss and pulmonary function , 2009, BMC Cancer.

[15]  J. Samet,et al.  Body mass index and cancer risk in Korean men and women , 2008, International journal of cancer.

[16]  Bernard Rachet,et al.  Cancer survival in five continents: a worldwide population-based study (CONCORD). , 2008, The Lancet. Oncology.

[17]  P. Brennan,et al.  Anthropometric factors and breast cancer risk among urban and rural women in South India: a multicentric case–control study , 2008, British Journal of Cancer.

[18]  H. Kennedy,et al.  Pancreatic cancer: a review of the evidence on causation. , 2008, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[19]  V. Somers,et al.  Accuracy of body mass index in diagnosing obesity in the adult general population , 2008, International Journal of Obesity.

[20]  M. Zwahlen,et al.  Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies , 2008, The Lancet.

[21]  D. Silverman,et al.  Adiposity, physical activity, and pancreatic cancer in the National Institutes of Health-AARP Diet and Health Cohort. , 2007, American journal of epidemiology.

[22]  A. Tamakoshi,et al.  Obesity, physical activity and the risk of pancreatic cancer in a large Japanese cohort , 2007, International journal of cancer.

[23]  S. Larsson,et al.  Body mass index and pancreatic cancer risk: A meta‐analysis of prospective studies , 2007, International journal of cancer.

[24]  M. Inoue,et al.  Body mass index, physical activity and the risk of pancreatic cancer in relation to smoking status and history of diabetes: a large-scale population-based cohort study in Japan–The JPHC study , 2007, Cancer Causes & Control.

[25]  U. Nöthlings,et al.  Body mass index and physical activity as risk factors for pancreatic cancer: the Multiethnic Cohort Study , 2007, Cancer Causes & Control.

[26]  F. Clavel-Chapelon,et al.  Anthropometry, Physical Activity, and the Risk of Pancreatic Cancer in the European Prospective Investigation into Cancer and Nutrition , 2006, Cancer Epidemiology Biomarkers & Prevention.

[27]  M. Schulze,et al.  Body mass index history and risk of type 2 diabetes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. , 2006, The American journal of clinical nutrition.

[28]  E. Holly,et al.  Anthropometric Factors and Pancreatic Cancer in a Population-based Case–control Study in the San Francisco Bay Area , 2005, Cancer Causes & Control.

[29]  S. Larsson,et al.  Overall obesity, abdominal adiposity, diabetes and cigarette smoking in relation to the risk of pancreatic cancer in two Swedish population-based cohorts , 2005, British Journal of Cancer.

[30]  C. Fuchs,et al.  Obesity and Pancreatic Cancer: Overall Evidence and Latency Period , 2005, Cancer Epidemiology Biomarkers & Prevention.

[31]  L. Gullo,et al.  Obesity and the Risk of Pancreatic Cancer: An Italian Multicenter Study , 2005, Pancreas.

[32]  J. Greenson,et al.  The association of body mass index and pancreatic cancer in residents of southeastern Michigan, 1996-1999. , 2005, American journal of epidemiology.

[33]  E. John,et al.  Obesity before age 30 years and risk of advanced prostate cancer. , 2005, American Journal of Epidemiology.

[34]  M. Thun,et al.  Obesity, Recreational Physical Activity, and Risk of Pancreatic Cancer In a Large U.S. Cohort , 2005, Cancer Epidemiology Biomarkers & Prevention.

[35]  W. Willett,et al.  Dietary glycemic load, carbohydrate, sugar, and colorectal cancer risk in men and women. , 2005, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[36]  J. Seidell,et al.  Epidemiology of obesity. , 2002, Seminars in vascular medicine.

[37]  S. Daniels,et al.  Race differences in accuracy of self-reported childhood body size among white and black women. , 2004, Obesity research.

[38]  S. Wen,et al.  Association of obesity and cancer risk in Canada. , 2004, American journal of epidemiology.

[39]  F Berrino,et al.  EUROCARE-3: survival of cancer patients diagnosed 1990-94--results and commentary. , 2003, Annals of oncology : official journal of the European Society for Medical Oncology.

[40]  A. D. de González,et al.  A meta-analysis of obesity and the risk of pancreatic cancer , 2003, British Journal of Cancer.

[41]  F Xavier Pi-Sunyer,et al.  The obesity epidemic: pathophysiology and consequences of obesity. , 2002, Obesity research.

[42]  G A Colditz,et al.  Physical activity, obesity, height, and the risk of pancreatic cancer. , 2001, JAMA.

[43]  J. Yarnell,et al.  Comparison of weight in middle age, weight at 18 years, and weight change between, in predicting subsequent 14 year mortality and coronary events: Caerphilly Prospective Study , 2000, Journal of epidemiology and community health.

[44]  A. Wolk,et al.  Body size in different periods of life and breast cancer risk in post-menopausal women. , 1998, International journal of cancer.

[45]  W E Fisher,et al.  Insulin promotes pancreatic cancer: evidence for endocrine influence on exocrine pancreatic tumors. , 1996, The Journal of surgical research.

[46]  D. V. Von Hoff,et al.  A phase II trial of gemcitabine in patients with 5-FU-refractory pancreas cancer. , 1996, Annals of oncology : official journal of the European Society for Medical Oncology.

[47]  N. Abate Insulin Resistance and Obesity: The role of fat distribution pattern , 1996, Diabetes Care.

[48]  M. Korc,et al.  Insulin-like growth factor I overexpression in human pancreatic cancer: evidence for autocrine and paracrine roles. , 1995, Cancer research.

[49]  T. Byers,et al.  THE VALIDITY OF SELF‐REPORTS OF PAST BODY WEIGHTS BY U.S. ADULTS , 1995, Epidemiology.

[50]  W. Willett,et al.  Remote recall of childhood height, weight, and body build by elderly subjects. , 1993, American journal of epidemiology.

[51]  K. A. Coleman,et al.  Long-term memory of body weight and past weight satisfaction: a longitudinal follow-up study. , 1991, The American journal of clinical nutrition.