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Central adiposity, obesity during early adulthood, and pancreatic cancer mortality in a pooled analysis of cohort studies.
Genkinger, J M; Kitahara, C M; Bernstein, L; Berrington de Gonzalez, A; Brotzman, M; Elena, J W; Giles, G G; Hartge, P; Singh, P N; Stolzenberg-Solomon, R Z; Weiderpass, E; Adami, H-O; Anderson, K E; Beane-Freeman, L E; Buring, J E; Fraser, G E; Fuchs, C S; Gapstur, S M; Gaziano, J M; Helzlsouer, K J; Lacey, J V; Linet, M S; Liu, J J; Park, Y; Peters, U; Purdue, M P; Robien, K; Schairer, C; Sesso, H D; Visvanathan, K; White, E; Wolk, A; Wolpin, B M; Zeleniuch-Jacquotte, A; Jacobs, E J.
Affiliation
  • Genkinger JM; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York jg3081@columbia.edu.
  • Kitahara CM; Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda.
  • Bernstein L; Division of Cancer Etiology, City of Hope National Medical Center, Duarte.
  • Berrington de Gonzalez A; Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda.
  • Brotzman M; Westat, Rockville.
  • Elena JW; Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, DHHS, Bethesda, USA.
  • Giles GG; Cancer Epidemiology Centre, Cancer Council of Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
  • Hartge P; Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda.
  • Singh PN; Department of Epidemiology, Biostatistics and Population Medicine and The Center for Health Research, Loma Linda University School of Medicine, Loma Linda, USA.
  • Stolzenberg-Solomon RZ; Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda.
  • Weiderpass E; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø Department of Research, Cancer Registry of Norway, Oslo, Norway Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Genetic Epidemiol
  • Adami HO; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Department of Epidemiology, Harvard School of Public Health, Boston.
  • Anderson KE; Division of Epidemiology and Community Health, School of Public Health, and Masonic Cancer Center, University of Minnesota, Minneapolis.
  • Beane-Freeman LE; Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda.
  • Buring JE; Department of Epidemiology, Harvard School of Public Health, Boston Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston.
  • Fraser GE; Department of Epidemiology, Biostatistics and Population Medicine and The Center for Health Research, Loma Linda University School of Medicine, Loma Linda, USA.
  • Fuchs CS; Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston Department of Medical Oncology, Dana-Farber Cancer Institute, Boston.
  • Gapstur SM; Epidemiology Research Program, American Cancer Society, Atlanta.
  • Gaziano JM; Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston Massachusetts Veterans Epidemiology Research and Information Center, Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston.
  • Helzlsouer KJ; The Prevention & Research Center, Mercy Medical Center, Baltimore Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore.
  • Lacey JV; Division of Cancer Etiology, City of Hope National Medical Center, Duarte.
  • Linet MS; Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda.
  • Liu JJ; Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda.
  • Park Y; Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda Division of Public Health Sciences, Washington University School of Medicine, St Louis.
  • Peters U; Fred Hutchinson Cancer Research Center, Seattle Department of Epidemiology, University of Washington, Seattle.
  • Purdue MP; Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda.
  • Robien K; Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington.
  • Schairer C; Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda.
  • Sesso HD; Department of Epidemiology, Harvard School of Public Health, Boston Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston.
  • Visvanathan K; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Department of Medical Oncology, Sidney Kimmel Cancer Center, John Hopkins School of Medicine, Baltimore, USA.
  • White E; Fred Hutchinson Cancer Research Center, Seattle Department of Epidemiology, University of Washington, Seattle.
  • Wolk A; Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
  • Wolpin BM; Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston Department of Medical Oncology, Dana-Farber Cancer Institute, Boston.
  • Zeleniuch-Jacquotte A; Department of Population Health and Perlmutter Cancer Center, New York University, New York, USA.
  • Jacobs EJ; Epidemiology Research Program, American Cancer Society, Atlanta.
Ann Oncol ; 26(11): 2257-66, 2015 Nov.
Article in En | MEDLINE | ID: mdl-26347100
ABSTRACT

BACKGROUND:

Body mass index (BMI), a measure of obesity typically assessed in middle age or later, is known to be positively associated with pancreatic cancer. However, little evidence exists regarding the influence of central adiposity, a high BMI during early adulthood, and weight gain after early adulthood on pancreatic cancer risk.

DESIGN:

We conducted a pooled analysis of individual-level data from 20 prospective cohort studies in the National Cancer Institute BMI and Mortality Cohort Consortium to examine the association of pancreatic cancer mortality with measures of central adiposity (e.g. waist circumference; n = 647 478; 1947 pancreatic cancer deaths), BMI during early adulthood (ages 18-21 years) and BMI change between early adulthood and cohort enrollment, mostly in middle age or later (n = 1 096 492; 3223 pancreatic cancer deaths). Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models.

RESULTS:

Higher waist-to-hip ratio (HR = 1.09, 95% CI 1.02-1.17 per 0.1 increment) and waist circumference (HR = 1.07, 95% CI 1.00-1.14 per 10 cm) were associated with increased risk of pancreatic cancer mortality, even when adjusted for BMI at baseline. BMI during early adulthood was associated with increased pancreatic cancer mortality (HR = 1.18, 95% CI 1.11-1.25 per 5 kg/m(2)), with increased risk observed in both overweight and obese individuals (compared with BMI of 21.0 to <23 kg/m(2), HR = 1.36, 95% CI 1.20-1.55 for BMI 25.0 < 27.5 kg/m(2), HR = 1.48, 95% CI 1.20-1.84 for BMI 27.5 to <30 kg/m(2), HR = 1.43, 95% CI 1.11-1.85 for BMI ≥30 kg/m(2)). BMI gain after early adulthood, adjusted for early adult BMI, was less strongly associated with pancreatic cancer mortality (HR = 1.05, 95% CI 1.01-1.10 per 5 kg/m(2)).

CONCLUSIONS:

Our results support an association between pancreatic cancer mortality and central obesity, independent of BMI, and also suggest that being overweight or obese during early adulthood may be important in influencing pancreatic cancer mortality risk later in life.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pancreatic Neoplasms / Obesity, Abdominal / Obesity Type of study: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limits: Adolescent / Adult / Humans Language: En Journal: Ann Oncol Journal subject: NEOPLASIAS Year: 2015 Type: Article
Fulltext
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PubMed Links
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pancreatic Neoplasms / Obesity, Abdominal / Obesity Type of study: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limits: Adolescent / Adult / Humans Language: En Journal: Ann Oncol Journal subject: NEOPLASIAS Year: 2015 Type: Article