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Cited by 159Cancer Risks and FactorsPancreatic and Hepatic Oncology ResearchObesity, Physical Activity, Diet

Central adiposity, obesity during early adulthood, and pancreatic cancer mortality in a pooled analysis of cohort studies

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Genkinger, J.M., Kitahara, C.M., Bernstein, L., Berrington de Gonzalez, A., Brotzman, M., Elena, J.W., Giles, G.G., Hartge, P. +27 more·2015·Annals of Oncology
DOI 10.1093/annonc/mdv355PMC PMC4621029
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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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  • Persons who are overweight or obese may have increased risk of a variety of cancers, although risk may be modified by age, sex, race, menopausal status, duration of obesity, adiposity distribution, and presence of additional metabolic syndrome components.

    “Persons who are overweight (>25 kg/m2) or obese (>30 kg/m2) may have an increased risk of a variety of cancers, although risk may be modified by age, sex, race, menopausal status, duration of obesity, anthropomorphic distribution of adiposity, and the presence of additional metabolic syndrome components.1730,1732–1738”

    From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1735]

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  • The inverse BMI-prostate cancer relationship may depend on racial background, with increased risk in African American men.

    “but this may be dependent on racial background with increased risk in African American men.1735”

    From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1735]

    The Discussion addresses BMI and pancreatic cancer mortality, not prostate cancer. The Statistical Methods say the models adjusted for race, but neither that section nor the passages found by searching for prostate cancer and African American men report a race-dependent BMI–prostate cancer relationship. (LLM, conf=0.78)

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  1. [28]28. Beeson WL, Mills PK, Phillips RL et al. Chronic disease among Seventh-day Adventists, a low-risk group. Rationale, methodology, and description of the population. Cancer 1989; 64: 570-581.

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Authors
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.
Affiliations
  • Columbia University Irving Medical Center (US)
  • National Cancer Institute (US)
  • City Of Hope National Medical Center (US)
  • Westat (United States) (US)
  • United States Department of Health and Human Services (US)
  • The University of Melbourne (AU)
  • Loma Linda University Medical Center (US)
  • Karolinska Institutet (SE)
  • Harvard University (US)
  • University of Minnesota (US)
  • Brigham and Women's Hospital (US)
  • American Cancer Society (US)
  • Mercy Medical Center (US)
  • University of Washington (US)
  • George Washington University (US)
  • Johns Hopkins University (US)
Corresponding author
Genkinger, J.M.
ORCID
Venue
Annals of Oncology
Publisher
Elsevier BV
Published
2015-11
Volume
26
Issue
11
Pages
2257-2266
ISSN
0923-7534 (ISSN-L)
DOI
10.1093/annonc/mdv355
PMC
PMC4621029
OpenAlex
W2119625192
Cited by
159
References
63
Citations by year
2026: 5 · 2025: 11 · 2024: 10 · 2023: 6 · 2022: 27 · 2021: 19 · 2020: 18 · 2019: 23 · 2018: 14 · 2017: 19 · 2016: 7
FWCI
1.43
Type
journal article
Language
en
Open access
Licence
Locations
  • Annals of Oncology (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Cancer Institute (Z99 CA999999, R01- HL26210, Z01 P010119, CA 77398, R01 CA105069, CA105069, R01 CA39742)
  • NIH
  • National Institutes of Health (R01-CA14703, K05 CA154337)
  • National Heart, Lung and Blood Institute
  • National Institute of Environmental Health Sciences (Z01 ES 049030-11, CA 97193, CA 34944, CA 40360, HL 26490, HL 34595)
  • American Cancer Society
  • National Institute of Aging (5U01AG018033, U01 AG18033)
  • Maryland Cancer Registry, Center for Cancer Surveillance and Control
  • Maryland Cigarette Restitution Fund
  • Centers for Disease Control and Prevention
  • Swedish Research Council
  • Swedish Council for Working Life and Social Research
  • Swedish Cancer Foundation
  • NCI (P01 CA055075, UM1 CA167552, UM1 CA186107, P01 CA87969, R01 CA49449, R01 CA 098661, CA 016087)
  • Cancer Council Victoria
  • Australian NHMRC (209057, 251533, 396414, 504715)
  • the National Cancer Institute (ES 000260)
  • Swedish Research Council, Swedish Council for Working Life and Social Research
  • National Cancer Institute and Office of Dietary Supplements (CA047988, HL043851, HL080467)
  • Swedish Cancer Society
Topics
  • Health Sciences › Medicine › Oncology › Cancer Risks and Factors
  • Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
pancreatic cancer mortality, abdominal obesity, waist-to-hip ratio, waist circumference, body mass index, early adulthood, childhood obesity, weight gain, BMI change, obesity, overweight, cancer risk factors, pooled cohort analysis
MeSH terms
Adolescent, Humans, Obesity, Pancreatic Neoplasms, Risk Factors, Cohort Studies, Waist Circumference, Young Adult, Obesity, Abdominal

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