Intake of Fruits and Vegetables and Risk of Pancreatic Cancer in a Pooled Analysis of 14 Cohort Studies

University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
American journal of epidemiology (Impact Factor: 4.98). 08/2012; 176(5):373-86. DOI: 10.1093/aje/kws027
Source: PubMed

ABSTRACT Fruit and vegetable intake may protect against pancreatic cancer, since fruits and vegetables are rich in potentially cancer-preventive nutrients. Most case-control studies have found inverse associations between fruit and vegetable intake and pancreatic cancer risk, although bias due to reporting error cannot be ruled out. In most prospective studies, inverse associations have been weaker and imprecise because of small numbers of cases. The authors examined fruit and vegetable intake in relation to pancreatic cancer risk in a pooled analysis of 14 prospective studies from North America, Europe, and Australia (study periods between 1980 and 2005). Relative risks and 2-sided 95% confidence intervals were estimated separately for the 14 studies using the Cox proportional hazards model and were then pooled using a random-effects model. Of 862,584 men and women followed for 7-20 years, 2,212 developed pancreatic cancer. The pooled multivariate relative risks of pancreatic cancer per 100-g/day increase in intake were 1.01 (95% confidence interval (CI): 0.99, 1.03) for total fruits and vegetables, 1.01 (95% CI: 0.99, 1.03) for total fruits, and 1.02 (95% CI: 0.99, 1.06) for total vegetables. Associations were similar for men and women separately and across studies. These results suggest that fruit and vegetable intake during adulthood is not associated with a reduced pancreatic cancer risk.

  • Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 03/2014; 12(10). DOI:10.1016/j.cgh.2014.02.032 · 6.53 Impact Factor
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    ABSTRACT: Pancreatic cancer (PC) is one of the most challenging tumor entities worldwide, characterized as a highly aggressive disease with dismal overall prognosis and an incidence rate equalling mortality rate. Over the last decade, substantial progress has been made to define the morphological changes and key genetic events in pancreatic carcinogenesis. And yet, it is still unclear what factors trigger PC. Some risk factors appear to be associated with sex, age, race/ethnicity, or other rare genetic conditions. Additionally, modifying factors such as smoking, obesity, diabetes, occupational risk factors, etc., increase the potential for acquiring genetic mutations that may result in PC. Another hallmark of PC is its poor response to radio- and chemo-therapy. Current chemotherapeutic regimens could not provide substantial survival benefit with a clear increase in overall survival. Recently, several new approaches to significantly improve the clinical outcome of PC have been described involving downstream signaling cascades desmoplasia and stromal response as well as tumor microenvironment, immune response, vasculature, and angiogenesis. This review summarizes major risk factors for PC and tries to illuminate relevant targets considerable for new therapeutic approaches.
    Frontiers in Oncology 01/2013; 3:282. DOI:10.3389/fonc.2013.00282
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    ABSTRACT: Background & Aims Pancreatic diseases place significant burdens on health care systems worldwide. However, there is lack of agreement about which factors increase or reduce risk for pancreatic disease. We reviewed high-quality studies of risk factors for pancreatic diseases in the general population. Methods We searched 3 databases (Medline, EMBASE, and Scopus) for prospective cohort studies of modifiable risk and/or protective factors for acute pancreatitis, chronic pancreatitis, and pancreatic cancer in adult populations. Factors that were investigated in 2 or more studies were assessed by meta-analysis, if the required data available. Subgroup analyses were performed when appropriate. Outcome measures were relative risk (RR) and 95% confidence interval (CI). Results Our analysis included 51 population-based studies, with more than 3 million individuals and nearly 11 thousand patients with pancreatic diseases. A total of 31 different factors were investigated. Current tobacco use was the single most important risk factor for pancreatic diseases (RR, 1.87; 95% CI, 1.54–2.27), followed by obesity (RR, 1.48; 95% CI, 1.15–1.92) and heavy use of alcohol (RR, 1.37; 95% CI, 1.19–1.58). Tobacco and heavy use of alcohol had bigger effects on risk of acute pancreatitis and chronic pancreatitis than pancreatic cancer. Vegetable consumption (RR, 0.71; 95% CI, 0.57–0.88) and fruit consumption (RR, 0.73; 95% CI, 0.60–0.90) provided the greatest degree of protection against pancreatic diseases, based on meta-analyses. Vegetable consumption had a stronger association with protection against acute pancreatitis, and fruit consumption with protection against pancreatic cancer. Conclusions Based on systematic review and meta-analysis, current tobacco use, obesity, and heavy use of alcohol are associated with significantly increases in risk for pancreatic diseases. Vegetables and fruit consumption are associated with reduced risk for pancreatic diseases. Prevention strategies for acute pancreatitis, chronic pancreatitis, and pancreatic cancer should consider these factors.
    Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 10/2014; 12(10). DOI:10.1016/j.cgh.2014.01.038 · 6.53 Impact Factor