Lifetime adiposity and risk of pancreatic cancer in the NIH-AARP Diet and Health Study cohort

Am J Clin Nutr. 2013 Oct;98(4):1057-65. doi: 10.3945/ajcn.113.058123. Epub 2013 Aug 28.


Background: The association of excess body weight across a lifetime with pancreatic cancer has not been examined extensively.

Objective: We determined the association for body mass index (BMI) at different ages and adiposity duration and gain with incident pancreatic adenocarcinoma in the NIH-AARP Diet and Health Study cohort.

Design: Participants aged 50-71 y completed questionnaires at baseline (1995-1996) and 6 months later that queried height and weight history. We calculated HRs and 95% CIs by using Cox proportional hazards models adjusted for age, smoking, sex, and intakes of energy and total fat.

Results: Over an average follow-up of 10.5 y, 1206 and 2122 pancreatic cancer cases were identified in the subcohort who completed the second questionnaire (n = 273,975) and the baseline cohort (n = 501,698), respectively. Compared with normal weight, overweight or obesity at ages 18, 35, 50, or >50 y (baseline BMI) was significantly associated with pancreatic cancer, with HRs ranging from 1.15 to 1.53. A longer duration of BMI (in kg/m(2)) >25.0 was significantly associated with pancreatic cancer (overall HR per 10-y increment of duration: 1.06; 95% CI: 1.02, 1.09), with individuals who reported diabetes having the greatest risk (HR per 10-y increment of duration: 1.18; 95% CI: 1.05, 1.32; P-interaction = 0.01) and rates. A substantial gain in adiposity (>10 kg/m(2)) after age 50 y was significantly associated with increased pancreatic cancer risk. The etiologic fraction of pancreatic cancer explained by adiposity at any age was 14% overall and 21% in never smokers.

Conclusion: Overweight and obesity at any age are associated with increased pancreatic cancer.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / etiology*
  • Adiposity*
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Body Mass Index*
  • Cohort Studies
  • Diet
  • Female
  • Humans
  • Male
  • Middle Aged
  • National Institutes of Health (U.S.)
  • Obesity / complications*
  • Overweight / complications*
  • Pancreatic Neoplasms / epidemiology
  • Pancreatic Neoplasms / etiology*
  • Proportional Hazards Models
  • Risk Factors
  • Surveys and Questionnaires
  • Time Factors
  • United States