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. 2018 Jan;7(1):229-239.
doi: 10.1002/cam4.1261. Epub 2017 Dec 22.

Smoking, alcohol, and diet in relation to risk of pancreatic cancer in China: a prospective study of 0.5 million people

Yuanjie Pang  1 , Michael V Holmes  1   2   3 , Yu Guo  4 , Ling Yang  1   2 , Zheng Bian  4 , Yiping Chen  1   2 , Andri Iona  1   2 , Iona Y Millwood  1   2 , Fiona Bragg  1 , Junshi Chen  5 , Liming Li  3   6 , Christiana Kartsonaki  1   2 , Zhengming Chen  1
Affiliations

Smoking, alcohol, and diet in relation to risk of pancreatic cancer in China: a prospective study of 0.5 million people

Yuanjie Pang et al. Cancer Med. 2018 Jan.

Abstract

In China, the incidence of pancreatic cancer (PC) has increased in recent decades. However, little is known about the relevance to PC risk of lifestyle and behavioral factors such as smoking, alcohol drinking, and diet. The China Kadoorie Biobank prospective study recruited 512,891 adults (210,222 men, 302,669 women) aged 30-79 (mean 52) years from 10 diverse areas during 2004-08. During ~9 years of follow-up, 688 incident cases of PC were recorded among those who had no prior history of cancer at baseline. Cox regression yielded adjusted hazard ratios (HR) for PC associated with smoking, alcohol and selected dietary factors. Overall, 74% of men were ever-regular smokers and 33% of men drank at least weekly, compared with only 3% and 2% of women, respectively. Among men, current regular smoking was associated with an adjusted HR of 1.25 (95% CI 1.08-1.44) for PC, with greater excess risk in urban than rural areas (1.46 [1.19-1.79] vs 1.04 [0.86-1.26]). Heavy, but not light to moderate, alcohol drinking (i.e. ≥420 g/week) was associated with significant excess risk (1.69 [1.21-2.37]), again more extreme in urban than rural areas (1.93 [1.29-2.87] vs 1.35 [0.74-2.48]). Overall, regular consumption of certain foodstuffs was associated with PC risk, with adjusted daily vs never/rare consumption HRs of 0.66 (0.56-0.79) for fresh fruit and 1.16 (1.01-1.33) for red meat. In China, smoking and heavy alcohol drinking were independent risk factors for PC in men. Lower fresh fruit and higher red meat consumption were also associated with higher risk of PC.

Keywords: Alcohol; Chinese; fresh fruit; meat; pancreatic cancer; smoking.

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Figures

Figure 1
Figure 1
Adjusted HRs for PC by self‐reported intake frequency of dietary fraction. Intake frequency was classified as never/rarely (reference), monthly, weekly (1–3 days/week), and daily or almost daily (≥4 days/week and daily). The boxes represent hazard ratios and the vertical lines represent 95% confidence intervals. The sizes of the boxes are proportional to the inverse of the variance of the log hazard ratios. The numbers above the vertical lines are point estimates for hazard ratios, and the numbers below the lines are numbers of events. The models were stratified by age‐at‐risk, sex and study area, and adjusted for education, smoking, alcohol, BMI, and total physical activity.
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