Body mass index, effect modifiers, and risk of pancreatic cancer: A pooled study of seven prospective cohorts

Li Jiao, Amy Berrington De Gonzalez, Patricia Hartge, Ruth M. Pfeiffer, Yikyung Park, D. Michal Freedman, Mitchell H. Gail, Michael C.R. Alavanja, Demetrius Albanes, Laura E. Beane Freeman, Wong Ho Chow, Wen Yi Huang, Richard B. Hayes, Jane A. Hoppin, Bu Tian Ji, Michael F. Leitzmann, Martha S. Linet, Cari L. Meinhold, Catherine Schairer, Arthur SchatzkinJarmo Virtamo, Stephanie J. Weinstein, Wei Zheng, Rachael Z. Stolzenberg-Solomon

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109 Scopus citations


Objective: To investigate whether the positive association of body mass index (BMI, kg/m2) with risk of pancreatic cancer is modified by age, sex, smoking status, physical activity, and history of diabetes. Methods: In a pooled analysis of primary data of seven prospective cohorts including 458,070 men and 485,689 women, we identified 2,454 patients with incident pancreatic cancer during an average 6.9 years of follow-up. Cox proportional hazard regression models were used in data analysis. Results: In a random-effects meta-analysis, for every 5 kg/m2 increment in BMI, the summary relative risk (RR) was 1.06 (95% confidence interval (CI) 0.99-1.13) for men and 1.12 (95% CI 1.05-1.19) for women. The aggregate analysis showed that compared with normal weight (BMI: 18.5 to <25), the adjusted RR was 1.13 (95% CI 1.03-1.23) for overweight (BMI: 25 to <30) and 1.19 (95% CI 1.05-1.35) for obesity class I (BMI: 30 to <35). Tests of interactions of BMI effects by other risk factors were not statistically significant. Every 5 kg/m2 increment in BMI was associated with an increased risk of pancreatic cancer among never and former smokers, but not among current smokers (P-interaction = 0.08). Conclusion: The present evidence suggests that a high BMI is an independent risk factor of pancreatic cancer.

Original languageEnglish
Pages (from-to)1305-1314
Number of pages10
JournalCancer Causes and Control
Issue number8
StatePublished - Aug 2010


  • Body mass index
  • Effect modification
  • Pancreatic cancer
  • Pooled analysis
  • Prospective cohort


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