Objective
The effects of BMI and physical activity on the risk of pancreatic cancer were investigated in a large population-based cohort
study in Japan (JPHC study). In particular, we explored how these effects were influenced by smoking status and a history
of diabetes.
Methods
In total, 99,670 participants (47,499 men, and 52,171women) were followed for an average of 11 years through the end of 2003.
Hazard ratios (HR) and their 95% confidence intervals (CI) were estimated by Cox proportional hazards models.
Results
A total of 224 incident cases (128 men, 96 women) of pancreatic cancer were identified. A statistically significant excess
risk of pancreatic cancer was associated with current smoking (HR = 1.8, CI 1.1–3.0) and a history of diabetes (HR = 2.1,
CI 1.3–3.5) among men. A similar increase in risk associated with current smoking (HR = 2.0, CI 0.9–4.4) and diabetes (HR = 1.5,
CI 0.7–3.5) was also seen among women. BMI was inversely associated with risk of pancreatic cancer among men, especially among
current male smokers or diabetes patients, but no association was found among women. Leisure-time physical activity was not
associated with risk in either men or women.
Conclusions
Our study confirms the association between cigarette smoking, history of diabetes and increased risk of pancreatic cancer.
However, our data suggest that the association between BMI and risk of pancreatic cancer in this Japanese population may be
different from that in Western populations.
Keywords BMI - Physical activity - Pancreatic cancer - Risk factors - Smoking - diabetes
Members of the JPHC Study Group (principal investigator: S. Tsugane): S. Tsugane, M. Inoue, T. Hanaoka and T. Sobue, National
Cancer Center, Tokyo; J. Ogata, S. Baba, T. Mannami and A. Okayama, National Cardiovascular Center, Suita; K. Miyakawa, F.
Saito, A. Koizumi, Y. Sano and I. Hashimoto, Iwate Prefectural Ninohe Public Health Center, Ninohe; Y. Miyajima, N. Suzuki,
S. Nagasawa, Y. Furusugi and N. Nagai, Akita Prefectural Yokote Public Health Center, Yokote; H. Sanada, Y. Hatayama, F. Kobayashi,
H. Uchino, Y. Shirai, T. Kondo, R. Sasaki, Y. Watanabe and Y. Miyakawa, Nagano Prefectural Saku Public Health Center, Saku;
Y. Kishimoto, E. Takara, T. Fukuyama, M. Kinjo, M. Irei and H. Sakiyama, Okinawa Prefectural Ishikawa (Chubu) Public Health
Centre, Ishikawa; K. Imoto, H. Yazawa, T. Seo, A. Seiko, F. Ito and F. Shoji, Katsushika Public Health Center, Tokyo; A. Murata,
K. Minato, K. Motegi and T. Fujieda, Ibaraki Prefectural Kasama (Mito) Public Health Centre, Mito; K. Matsui, T. Abe and M.
Katagiri, Niigata Prefectural Kashiwazaki Public Health Center, Kashiwazaki; M. Doi, A. Terao and Y. Ishikawa; Kochi Prefectural
Tosayamada (Chuo-higashi) Public Health Center, Tosayamada; H. Sueta, H. Doi, M. Urata, N. Okamoto and F. Ide, Nagasaki Prefectural
Arikawa (Kamigoto) Public Health Center, Arikawa; H. Sakiyama, N. Onga and H. Takaesu, Okinawa Prefectural Miyako Public Health
Center, Hirara; F. Horii, I. Asano, H.Yamaguchi, K. Aoki, S. Maruyama and M. Ichii, Osaka Prefectural Suita Public Health
Center, Suita; S. Matsushima and S. Natsukawa, Saku General Hospital, Usuda; S. Watanabe and M. Akabane, Tokyo University
of Agriculture, Tokyo; M. Konishi and K. Okada, Ehime University, Matsuyama; H. Iso, Osaka University, Osaka; Y. Honda and
K. Yamagishi, University of Tsukuba, Tsukuba; H. Sugimura, Hamamatsu University, Hamamatsu; Y. Tsubono, Tohoku University,
Sendai; M. Kabuto, National Institute for Environmental Studies, Tsukuba; S. Tominaga, Aichi Cancer Center Research Institute,
Nagoya; M. Iida and W. Ajiki, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka; S. Sato, Osaka Medical Center
for Health Science and Promotion, Osaka; N. Yasuda, Kochi University, Kochi; S. Kono, Kyushu University, Fukuoka; K. Suzuki,
Research Institute for Brain and Blood Vessels, Akita; Y. Takashima, Kyorin University, Mitaka; E. Maruyama, Kobe University,
Kobe; M. Yamaguchi, Y. Matsumura and S. Sasaki, National Institute of Health and Nutrition, Tokyo; and T. Kadowaki, Tokyo
University, Tokyo, Japan.