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American Journal of Epidemiology Advance Access originally published online on March 18, 2009
American Journal of Epidemiology 2009 169(9):1043-1051; doi:10.1093/aje/kwp034
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American Journal of Epidemiology Published by the Johns Hopkins Bloomberg School of Public Health 2009.

ORIGINAL CONTRIBUTIONS

Alcohol Use and Risk of Pancreatic Cancer

The NIH-AARP Diet and Health Study

Li Jiao, Debra T. Silverman, Catherine Schairer, Anne C. M. Thiébaut, Albert R. Hollenbeck, Michael F. Leitzmann, Arthur Schatzkin and Rachael Z. Stolzenberg-Solomon

Correspondence to Dr. Li Jiao, Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Boulevard, Room 3032, Rockville, MD 20852 (e-mail: jiaol{at}mail.nih.gov).

Received for publication September 15, 2008. Accepted for publication January 23, 2009.

The epidemiologic evidence for the role of alcohol use in pancreatic cancer development is equivocal. The authors prospectively examined the relation between alcohol use and risk of pancreatic cancer among 470,681 participants who were aged 50–71 years in 1995–1996 in the US National Institutes of Health-AARP Diet and Health Study. The authors identified 1,149 eligible exocrine pancreatic cancer cases through December 2003. Multivariate Cox proportional hazards regression models were used to calculate relative risks and 95% confidence intervals with the referent group being light drinkers (<1 drink/day). The relative risks of developing pancreatic cancer were 1.45 (95% confidence interval (CI): 1.17, 1.80; Ptrend = 0.002) for heavy total alcohol use (≥3 drinks/day, ~40 g of alcohol/day) and 1.62 (95% CI: 1.24, 2.10; Ptrend = 0.001) for heavy liquor use, compared with the respective referent group. The increased risk with heavy total alcohol use was seen in never smokers (relative risk = 1.35, 95% CI: 0.79, 2.30) and participants who quit smoking 10 or more years ago before baseline (relative risk = 1.41, 95% CI: 1.01, 2.00). These findings suggest a moderately increased pancreatic cancer risk with heavy alcohol use, particularly liquor; however, residual confounding by cigarette smoking cannot be completely excluded.

alcohol drinking; cohort studies; pancreatic neoplasms; risk; smoking

Abbreviations: CI, confidence interval; NIH, National Institutes of Health


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