A pooled analysis of body mass index and pancreatic cancer mortality in African Americans
Menée à partir des données de 7 études de cohorte portant au total sur 239 597 participants afro-américains, cette étude évalue l'association entre l'indice de masse corporelle et le risque de décès par cancer du pancréas
Background : Pancreatic cancer is a leading cause of cancer-related mortality in the U.S. and both incidence and mortality are highest in African Americans. Obesity is also disproportionately high in African Americans, but limited data are available on the relation of obesity to pancreatic cancer in this population. Methods : Seven large prospective cohort studies pooled data from African American participants. Body mass index (BMI) was calculated from self-reported height and weight at baseline. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for levels of BMI relative to BMI 18.5-24.9, with adjustment for covariates. Primary analyses were restricted to participants with ≥5 years of follow-up because weight loss prior to diagnosis may have influenced baseline BMI in cases who died during early follow-up. Results : In follow-up of 239,597 participants, 897 pancreatic cancer deaths occurred. HRs were 1.08 (95% CI, 0.90-1.31) for BMI 25.0-29.9, 1.25 (95% CI, 0.99-1.57) for BMI 30.0-34.9, and 1.31 (95% CI, 0.97-1.77) for BMI ≥35.0 among those with ≥5 years of follow-up (Ptrend = 0.03). The association was evident among both sexes and was independent of a history of diabetes. A stronger association was observed among never-smokers (BMI ≥30 vs. referent: HR = 1.44; 95% CI, 1.02-2.03) than among smokers (HR = 1.16; 95% CI, 0.87-1.54; Pinteraction = 0.02). Conclusion : The findings suggest that obesity is independently associated with increased pancreatic cancer mortality in African Americans. Impact: Interventions to reduce obesity may also reduce risk of pancreatic cancer mortality, particularly among never-smokers.