DIETARY AND NUTRITIONAL FACTORS AND PANCREATIC-CANCER - A CASE-CONTROL STUDY BASED ON DIRECT INTERVIEWS

Background: The relationship between diet and pancreatic cancer remain s unclear, In this study, we assessed the role of diet and nutrition a s risk factors for pancreatic cancer, using data obtained from direct interviews only, rather than data from less reliable interviews with n ext of kin. We evaluated whether dietary factors could explain the hig her incidence of pancreatic cancer experienced by black Americans comp ared with white Americans. Methods: We conducted a population-based ea se-control study of pancreatic cancer diagnosed in Atlanta (GA), Detro it (MI), and 10 New Jersey counties from August 1986 through April 198 9, Reliable dietary histories were obtained for 436 patients and 2003 general-population control subjects aged 30-79 years. Results: Obesity was associated with a statistically significant 50%-60% increased ris k of pancreatic cancer that was consistent by sex and race. Although t he magnitude of risk associated with obesity was identical in blacks a nd whites, a higher percentage of blacks mere obese than were whites ( women: 38% versus 16%; men: 27% versus 22%), A statistically significa nt positive trend in risk was observed with increasing caloric intake, with subjects in the highest quartile of calorie intake experiencing a 70% higher risk than those in the lowest quartile, A statistically s ignificant interaction between body mass index (weight in kg/height in m(2) for men and weight in kg/height in m(1.5) for women) and total c aloric intake was observed that was consistent by sex and race. Subjec ts in the highest quartile of both body mass index and caloric intake had a statistically significant 180% higher risk than those in the low est, quartile, Conclusions: Obesity is a risk factor for pancreatic ca ncer and appears to contribute to the higher risk of this disease amon g blacks than among whites in the United States, particularly among wo men. Furthermore, the interaction between body mass index and caloric intake suggests the importance of energy balance in pancreatic carcino genesis.