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Body mass index and risk, age of onset, and survival in patients with pancreatic cancer.

Abstract

CONTEXT

Obesity has been implicated as a risk factor for pancreatic cancer.

OBJECTIVE

To demonstrate the association of excess body weight across an age cohort and the risk, age of onset, and overall survival of patients with pancreatic cancer.

DESIGN, SETTING, AND PARTICIPANTS

A case-control study of 841 patients with pancreatic adenocarcinoma and 754 healthy individuals frequency matched by age, race, and sex. The study was conducted at a university cancer center in the United States from 2004 to 2008. Height and body weight histories were collected by personal interview starting at ages 14 to 19 years and over 10-year intervals progressing to the year prior to recruitment in the study.

MAIN OUTCOME MEASURES

The associations between patients' body mass index (BMI) and risk of pancreatic cancer, age at onset, and overall survival were examined by unconditional logistic regression, linear regression, and Cox proportional hazard regression models, respectively.

RESULTS

Individuals who were overweight (a BMI of 25-29.9) from the ages of 14 to 39 years (highest odds ratio [OR], 1.67; 95% confidence interval [CI], 1.20-2.34) or obese (a BMI > or = 30) from the ages of 20 to 49 years (highest OR, 2.58; 95% CI, 1.70-3.90) had an associated increased risk of pancreatic cancer, independent of diabetes status. The association was stronger in men (adjusted OR, 1.80; 95% CI, 1.45-2.23) by mean BMI from the ages of 14 to 59 years than in women (adjusted OR, 1.32; 95% CI, 1.02-1.70) and in ever smokers (adjusted OR, 1.75; 95% CI, 1.37-2.22) than in never smokers (adjusted OR, 1.46; 95% CI, 1.16-1.84). The population-attributable risk percentage of pancreatic cancer based on the mean BMI from the ages of 14 to 59 years was 10.3% for never smokers and 21.3% for ever smokers. Individuals who were overweight or obese from the ages of 20 to 49 years had an earlier onset of pancreatic cancer by 2 to 6 years (median age of onset was 64 years for patients with normal weight, 61 years for overweight patients [P = .02], and 59 years for obese patients [P < .001]). Compared with those with normal body weight and after adjusting for all clinical factors, individuals who were overweight or obese from the ages of 30 to 79 years or in the year prior to recruitment had reduced overall survival of pancreatic cancer regardless of disease stage and tumor resection status (overweight patients: hazard ratio, 1.26 [95% CI, 0.94-1.69], P = .04; obese patients: hazard ratio, 1.86 [95% CI, 1.35-2.56], P < .001).

CONCLUSIONS

Overweight or obesity during early adulthood was associated with a greater risk of pancreatic cancer and a younger age of disease onset. Obesity at an older age was associated with a lower overall survival in patients with pancreatic cancer.

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  • Authors+Show Affiliations

    ,

    Department of Gastrointestinal Medical Oncology, Unit 426, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA. dli@mdanderson.org

    , , , , ,

    Source

    JAMA 301:24 2009 Jun 24 pg 2553-62

    MeSH

    Adenocarcinoma
    Adolescent
    Adult
    Age of Onset
    Aged
    Body Mass Index
    Case-Control Studies
    Female
    Humans
    Male
    Middle Aged
    Obesity
    Overweight
    Pancreatic Neoplasms
    Regression Analysis
    Risk Factors
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    19549972

    Citation

    Li, Donghui, et al. "Body Mass Index and Risk, Age of Onset, and Survival in Patients With Pancreatic Cancer." JAMA, vol. 301, no. 24, 2009, pp. 2553-62.
    Li D, Morris JS, Liu J, et al. Body mass index and risk, age of onset, and survival in patients with pancreatic cancer. JAMA. 2009;301(24):2553-62.
    Li, D., Morris, J. S., Liu, J., Hassan, M. M., Day, R. S., Bondy, M. L., & Abbruzzese, J. L. (2009). Body mass index and risk, age of onset, and survival in patients with pancreatic cancer. JAMA, 301(24), pp. 2553-62. doi:10.1001/jama.2009.886.
    Li D, et al. Body Mass Index and Risk, Age of Onset, and Survival in Patients With Pancreatic Cancer. JAMA. 2009 Jun 24;301(24):2553-62. PubMed PMID: 19549972.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Body mass index and risk, age of onset, and survival in patients with pancreatic cancer. AU - Li,Donghui, AU - Morris,Jeffrey S, AU - Liu,Jun, AU - Hassan,Manal M, AU - Day,R Sue, AU - Bondy,Melissa L, AU - Abbruzzese,James L, PY - 2009/6/25/entrez PY - 2009/6/25/pubmed PY - 2009/6/27/medline SP - 2553 EP - 62 JF - JAMA JO - JAMA VL - 301 IS - 24 N2 - CONTEXT: Obesity has been implicated as a risk factor for pancreatic cancer. OBJECTIVE: To demonstrate the association of excess body weight across an age cohort and the risk, age of onset, and overall survival of patients with pancreatic cancer. DESIGN, SETTING, AND PARTICIPANTS: A case-control study of 841 patients with pancreatic adenocarcinoma and 754 healthy individuals frequency matched by age, race, and sex. The study was conducted at a university cancer center in the United States from 2004 to 2008. Height and body weight histories were collected by personal interview starting at ages 14 to 19 years and over 10-year intervals progressing to the year prior to recruitment in the study. MAIN OUTCOME MEASURES: The associations between patients' body mass index (BMI) and risk of pancreatic cancer, age at onset, and overall survival were examined by unconditional logistic regression, linear regression, and Cox proportional hazard regression models, respectively. RESULTS: Individuals who were overweight (a BMI of 25-29.9) from the ages of 14 to 39 years (highest odds ratio [OR], 1.67; 95% confidence interval [CI], 1.20-2.34) or obese (a BMI > or = 30) from the ages of 20 to 49 years (highest OR, 2.58; 95% CI, 1.70-3.90) had an associated increased risk of pancreatic cancer, independent of diabetes status. The association was stronger in men (adjusted OR, 1.80; 95% CI, 1.45-2.23) by mean BMI from the ages of 14 to 59 years than in women (adjusted OR, 1.32; 95% CI, 1.02-1.70) and in ever smokers (adjusted OR, 1.75; 95% CI, 1.37-2.22) than in never smokers (adjusted OR, 1.46; 95% CI, 1.16-1.84). The population-attributable risk percentage of pancreatic cancer based on the mean BMI from the ages of 14 to 59 years was 10.3% for never smokers and 21.3% for ever smokers. Individuals who were overweight or obese from the ages of 20 to 49 years had an earlier onset of pancreatic cancer by 2 to 6 years (median age of onset was 64 years for patients with normal weight, 61 years for overweight patients [P = .02], and 59 years for obese patients [P < .001]). Compared with those with normal body weight and after adjusting for all clinical factors, individuals who were overweight or obese from the ages of 30 to 79 years or in the year prior to recruitment had reduced overall survival of pancreatic cancer regardless of disease stage and tumor resection status (overweight patients: hazard ratio, 1.26 [95% CI, 0.94-1.69], P = .04; obese patients: hazard ratio, 1.86 [95% CI, 1.35-2.56], P < .001). CONCLUSIONS: Overweight or obesity during early adulthood was associated with a greater risk of pancreatic cancer and a younger age of disease onset. Obesity at an older age was associated with a lower overall survival in patients with pancreatic cancer. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/19549972/full_citation L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2009.886 DB - PRIME DP - Unbound Medicine ER -