Pancreatic Cancer

Several recent studies suggest that high body mass is associated with increased risk for pancreatic cancer in men and women, with relative risk estimates for obesity generally in the range of 1.5 to 2.0 (Table 3) (3,34,131,155,158,161-166). However, other studies found smaller positive associations (36,132,167) or, in some cases, no association (35,95,96,168,169). Further research is needed to refine the magnitude of the risk in both men and women and to explain the inconsistency in current estimates of risk. Many of these studies are based on small numbers of cases, and retrospective studies of adiposity are hampered by weight loss that accompanies pancreatic cancer and that often begins prior to diagnosis. In addition, smoking is an important potential confounder of the relationship between adiposity and pancreatic cancer, and the smoking habits of the various study populations and differential adequacy of control for smoking may partly explain differences across studies. It is thought that chronic hyperinsulinemia and glucose intolerance may contribute to an increased risk of pancreatic cancer, as suggested by the well-established positive association between diabetes and pancreatic cancer in prospective studies (170,171). A recent study suggests that individuals with the highest vs lowest quartiles of fasting serum levels of glucose and insulin, and insulin resistance, have more than a twofold increased risk of pancreatic cancer (172).

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