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American Journal of Epidemiology Advance Access published online on February 12, 2008

American Journal of Epidemiology, doi:10.1093/aje/kwm361
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American Journal of Epidemiology Published by the Johns Hopkins Bloomberg School of Public Health 2008.

ORIGINAL CONTRIBUTION

Adiposity, Physical Activity, and Pancreatic Cancer in the National Institutes of Health–AARP Diet and Health Cohort

Rachael Z. Stolzenberg-Solomon1, Kenneth Adams1, Michael Leitzmann1, Catherine Schairer2, Dominique S. Michaud3, Albert Hollenbeck4, Arthur Schatzkin1 and Debra T. Silverman5

1 Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD
2 Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD
3 Department of Epidemiology, Harvard School of Public Health, Boston, MA
4 Environmental Analysis Department, AARP, Washington, DC
5 Occupational Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD

Correspondence to Dr. Rachael Stolzenberg-Solomon, 6120 Executive Boulevard, Suite 320, Rockville, MD 20852 (e-mail: rs221z{at}nih.gov).

Received for publication March 23, 2007. Accepted for publication November 5, 2007.

Obesity and lack of physical activity have been inconsistently associated with pancreatic cancer. Using data from a self-administered baseline questionnaire (1995–1996), the authors investigated the association between adiposity and physical activity and pancreatic cancer in 495,035 participants of the National Institutes of Health–AARP Diet and Health Study who were aged 50–71 years. To avoid the influence of subclinical disease, follow-up time started 1 year after baseline, and subjects with a body mass index (BMI) of <18.5 kg/m2 were excluded. A subcohort (n = 302,060) completed a second questionnaire with information about physical activity and waist and hip circumference. During follow-up though 2000, 654 pancreatic cancer cases were identified. The authors used Cox proportional hazard models to generate adjusted hazard ratios and 95% confidence intervals. Compared with those with a BMI of 18.5–<25, those with a BMI of ≥35 had a 45% greater pancreatic cancer risk (95% confidence interval (CI): 1.04, 2.02; ptrend = 0.02). Significant positive associations for BMI were observed among nonsmokers (for BMI ≥35: hazard ratio = 1.70, 95% CI: 1.14, 2.53; ptrend = 0.004) but not recent smokers (pinteraction = 0.08). Waist circumference was positively associated with pancreatic cancer (fourth vs. first quartile: hazard ratio = 2.53, 95% CI: 1.13, 5.65; ptrend = 0.04) in women but not men. The authors observed no association with physical activity. Their results suggest a positive association between adiposity and pancreatic cancer.

adenocarcinoma; adiposity; body mass index; cohort studies; exercise; pancreatic neoplasms; smoking; waist-hip ratio

Abbreviations: BMI, body mass index; CI, confidence interval; HR, hazard ratio; MET, metabolic equivalent; NIH, National Institutes of Health


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