Normal BMI and Nonsmoking are associated with reduced risks of pancreatic cancer

Index Combines 5 Modifiable Lifestyle Factors Linked With Risk for Pancreatic Cancer CME/CE

News Author: Laurie Barclay, MD CME Author: Désirée Lie, MD, MSEd

May 5, 2009 — Having a high score vs a low score on an index combining 5 modifiable lifestyle factors predicted a substantially lower risk for the development of pancreatic cancer, according to the results of a large, prospective study reported in the April 27 issue of the Archives of Internal Medicine.

"Smoking, alcohol use, diet, body mass index ([BMI] calculated as weight in kilograms divided by height in meters squared), and physical activity have been studied independently in relation to pancreatic cancer," write Li Jiao, MD, from National Cancer Institute, National Institutes of Health in Bethesda, Maryland, and colleagues. "We generated a healthy lifestyle score to investigate their joint effect on risk of pancreatic cancer."

The study cohort consisted of 450,416 participants enrolled in the National Institutes of Health-AARP Diet and Health Study, who were aged 50 to 71 years, who completed the baseline food frequency questionnaire from 1995 to 1996 regarding diet and lifestyle information, and who were followed up through December 31, 2003. During follow-up, 1057 eligible incident pancreatic cancer cases were identified.

For each participant, 5 modifiable lifestyle factors were scored as unhealthy (0 points) or healthy (1 point), based on current epidemiologic evidence. One point was awarded for each of the following: nonsmoking, limited alcohol use, adherence to the Mediterranean dietary pattern, body mass index (= 18 and <>2), and regular physical activity. The combined score (0 - 5 points) was determined by adding the scores for each of the 5 factors. Relative risk for pancreatic cancer was estimated with Cox proportional hazards regression models.

The highest combined score (5 points) vs the lowest score (0 points) was associated with a 58% reduction in the risk for the development of pancreatic cancer in all participants (relative risk, 0.42; 95% confidence interval, 0.26 - 0.66; P for trend < .001). In this study cohort, scores of less than 5 points were associated with 27% of pancreatic cancer cases.

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