TY - JOUR
T1 - Central adiposity, obesity during early adulthood, and pancreatic cancer mortality in a pooled analysis of cohort studies
AU - Genkinger, Jeanine M.
AU - Kitahara, C. M.
AU - Bernstein, L.
AU - Berrington de Gonzalez, A.
AU - Brotzman, M.
AU - Elena, J. W.
AU - Giles, G. G.
AU - Hartge, P.
AU - Singh, P. N.
AU - Stolzenberg-Solomon, R. Z.
AU - Weiderpass, E.
AU - Adami, H. O.
AU - Anderson, K. E.
AU - Beane-Freeman, L. E.
AU - Buring, J. E.
AU - Fraser, G. E.
AU - Fuchs, C. S.
AU - Gapstur, S. M.
AU - Gaziano, J. M.
AU - Helzlsouer, K. J.
AU - Lacey, J. V.
AU - Linet, M. S.
AU - Liu, J. J.
AU - Park, Y.
AU - Peters, U.
AU - Purdue, M. P.
AU - Robien, K.
AU - Schairer, C.
AU - Sesso, H. D.
AU - Visvanathan, K.
AU - White, E.
AU - Wolk, A.
AU - Wolpin, B. M.
AU - Zeleniuch-Jacquotte, A.
AU - Jacobs, E. J.
N1 - Publisher Copyright:
© The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
PY - 2015/11
Y1 - 2015/11
N2 - 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/m2), with increased risk observed in both overweight and obese individuals (compared with BMI of 21.0 to <23 kg/m2, HR = 1.36, 95% CI 1.20-1.55 for BMI 25.0 < 27.5 kg/m2, HR = 1.48, 95% CI 1.20-1.84 for BMI 27.5 to <30 kg/m2, HR = 1.43, 95% CI 1.11-1.85 for BMI ≥30 kg/m2). 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/m2). 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.
AB - 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/m2), with increased risk observed in both overweight and obese individuals (compared with BMI of 21.0 to <23 kg/m2, HR = 1.36, 95% CI 1.20-1.55 for BMI 25.0 < 27.5 kg/m2, HR = 1.48, 95% CI 1.20-1.84 for BMI 27.5 to <30 kg/m2, HR = 1.43, 95% CI 1.11-1.85 for BMI ≥30 kg/m2). 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/m2). 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.
KW - BMI
KW - Central adiposity
KW - pancreatic cancer
KW - pooled analysis
UR - http://www.scopus.com/inward/record.url?scp=84947747164&partnerID=8YFLogxK
U2 - 10.1093/annonc/mdv355
DO - 10.1093/annonc/mdv355
M3 - Review article
C2 - 26347100
AN - SCOPUS:84947747164
SN - 0923-7534
VL - 26
SP - 2257
EP - 2266
JO - Annals of Oncology
JF - Annals of Oncology
IS - 11
ER -