A Cohort Study of Adolescent and Midlife Diet and Pancreatic Cancer Risk in the NIH-AARP Diet and Health Study

Am J Epidemiol. 2017 Aug 1;186(3):305-317. doi: 10.1093/aje/kwx036.


Given the long latency period of pancreatic cancer, exploring the influence of early and midlife exposures will further advance our understanding of the disease. We assessed associations between diet and pancreatic cancer incidence in the National Institutes of Health (NIH)-AARP (formerly American Association of Retired Persons) Diet and Health Study. In 1996, a total of 303,094 participants completed 2 food frequency questionnaires that assessed diet at ages 12-13 years and 10 years previously. We used Cox proportional hazards regression to estimate adjusted hazard ratios and 95% confidence intervals. Through the end of 2006, a total of 1,322 pancreatic cancer cases occurred (average follow up time = 10.1 years). When comparing the highest tertiles with the lowest, carbohydrate intake during adolescence (hazard ratio (HR) = 0.87, 95% confidence interval (CI): 0.76, 0.99), but not 10 years before baseline, was inversely associated with pancreatic cancer risk. Total fat intake 10 years before baseline was significantly associated with increased risk (HR = 1.17, 95% CI: 1.02, 1.34), while risk was higher for high fat intake during both adolescence and midlife. Calcium intake 10 years before baseline was associated with reduced risk (HR = 0.87, 95% CI: 0.76, 0.99), as was a change from low intake in adolescence to high intake in midlife (HR = 0.71, 95% CI: 0.54, 0.93). Our study found a number of dietary factors present during adolescence and midlife to be associated with pancreatic cancer.

Keywords: adolescent diet; cancer risk; diet; midlife diet; nutritional epidemiology; pancreatic cancer.

MeSH terms

  • Adolescent
  • Aged
  • Child
  • Cohort Studies
  • Diet / adverse effects*
  • Diet / statistics & numerical data
  • Diet Surveys
  • Dietary Fats / adverse effects
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / epidemiology
  • Pancreatic Neoplasms / etiology*
  • Proportional Hazards Models
  • Risk Factors
  • Surveys and Questionnaires


  • Dietary Fats