Journal of the National Cancer Institute Advance Access published online on June 26, 2009
JNCI Journal of the National Cancer Institute, doi:10.1093/jnci/djp168
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Published by Oxford University Press 2009.
ARTICLE |
Dietary Fatty Acids and Pancreatic Cancer in the NIH-AARP Diet and Health Study
Affiliations of authors: Nutritional Epidemiology Branch (ACMT, LJ, AJC, AS, RZS-S) and Occupational and Environmental Epidemiology Branch (DTS), Division of Cancer Epidemiology and Genetics, and Applied Research Program, Division of Cancer Control and Population Sciences (FET, AFS), National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD; AARP, Washington, DC (ARH)
Correspondence to: Rachael Z. Stolzenberg-Solomon, PhD, 6120 Executive Blvd, Ste 320, Rockville, MD 20852 (e-mail: rs221z{at}nih.gov).
Background: Previous research relating dietary fat, a modifiable risk factor, to pancreatic cancer has been inconclusive.
Methods: We prospectively analyzed the association between intakes of fat, fat subtypes, and fat food sources and exocrine pancreatic cancer in the National Institutes of Health–AARP Diet and Health Study, a US cohort of 308 736 men and 216 737 women who completed a 124-item food frequency questionnaire in 1995–1996. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models, with adjustment for energy intake, smoking history, body mass index, and diabetes. Statistical tests were two-sided.
Results: Over an average follow-up of 6.3 years, 865 men and 472 women were diagnosed with exocrine pancreatic cancer (45.0 and 34.5 cases per 100 000 person-years, respectively). After multivariable adjustment and combination of data for men and women, pancreatic cancer risk was directly related to the intakes of total fat (highest vs lowest quintile, 46.8 vs 33.2 cases per 100 000 person-years, HR = 1.23, 95% CI = 1.03 to 1.46; Ptrend = .03), saturated fat (51.5 vs 33.1 cases per 100 000 person-years, HR = 1.36, 95% CI = 1.14 to 1.62; Ptrend < .001), and monounsaturated fat (46.2 vs 32.9 cases per 100 000 person-years, HR = 1.22, 95% CI = 1.02 to 1.46; Ptrend = .05) but not polyunsaturated fat. The associations were strongest for saturated fat from animal food sources (52.0 vs 32.2 cases per 100 000 person-years, HR = 1.43, 95% CI = 1.20 to 1.70; Ptrend < .001); specifically, intakes from red meat and dairy products were both statistically significantly associated with increased pancreatic cancer risk (HR = 1.27 and 1.19, respectively).
Conclusion: In this large prospective cohort with a wide range of intakes, dietary fat of animal origin was associated with increased pancreatic cancer risk.
| CONTEXT AND CAVEATS Prior knowledge Fat consumption has been linked to pancreatic cancer risk in some studies but not in others. Study design Information concerning diet and pancreatic cancer incidence was collected for a cohort of 525 473 American men and women, aged 50–71 years, from the National Institutes of Health–AARP Diet and Health Study. All participants were given a food frequency questionnaire in 1995–1996, and some were given two 24-hour dietary recall surveys within a year. Nutrient intakes were calculated from US Department of Agriculture databases, and pancreatic cancer data were collected from state cancer registries. Only cancers that occurred 1 year or more after the initial survey data until the end of 2003 were considered. Participants were divided into quintiles on the basis of percent energy from fat consumption, and hazard ratios (HRs) for risk of pancreatic cancer were estimated using Cox proportional hazards models. Contribution After a mean of 6.3 years of follow-up, men and women in the highest quintile of fat consumption had 53% and 23% higher incidence of pancreatic cancer, respectively, compared with the lowest quintiles for each sex. After multivariable adjustment, the combined risk of pancreatic cancer in the highest quintile, compared with the lowest quintile, was related to the intake of total fat, saturated fat, and monounsaturated fat, and particularly with the intake of saturated fat from animal sources (HR = 1.43). Implications Intake of saturated fats, particularly from meats and dairy products, can increase pancreatic cancer risk. Limitations These results are mostly based on self-reported food intakes on a food frequency questionnaire. From the Editors
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Manuscript received October 26, 2008; revised May 6, 2009; accepted May 14, 2009.
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