Antonio Agudo1, Paula Jakszyn2,3, Valerie Cayssials4,5,6, Genevieve Buckland7, Marta Crous-Bou4,8, Catalina Bonet4, Elisabete Weiderpass9, Guri Skie10, Dagfinn Aune11,12,13, Alicia Heath11, Therese Haugdahl Nøst10, Giovanna Masala14, Claudia Agnoli15, Maria Santucci De Magistris16, Bas Bueno-de-Mesquita17, Jeroen Derksen18, Inge Huybrechts9, Pietro Ferrari9, Oscar Franklin19, Stina Bodén20, Matthias Schulze21,22, Jose Maria Huerta23,24, Aurelio Barricarte25,26,27, Carlotta Sacerdote28, Pilar Amiano27,29,30, Rosario Tumino31, Esther Molina-Montes27,32,33,34, Anne Tjønneland35, Cecilie Kyrø35, Gianluca Severi36,37, Marie-Christine Boutron-Ruault36, Vinciane Rebours38,39, Verena Katzke40. 1. Unit of Nutrition and Cancer. Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL. L'Hospitalet de Llobregat, Av. Gran Via 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain. a.agudo@iconcologia.net. 2. Unit of Nutrition and Cancer. Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL. L'Hospitalet de Llobregat, Av. Gran Via 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain. paujak@iconcologia.net. 3. Blanquerna School of Health Sciences, Ramon Llull University, Barcelona, Spain. paujak@iconcologia.net. 4. Unit of Nutrition and Cancer. Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL. L'Hospitalet de Llobregat, Av. Gran Via 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain. 5. Department of Public Health, Faculty of Veterinary, University of the Republic, Montevideo, Uruguay. 6. Department of Quantitative Methods, Faculty of Medicine, University of the Republic, Montevideo, Uruguay. 7. Center for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK. 8. Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, USA. 9. International Agency for Research On Cancer (IARC), 150 cours Albert Thomas, 69008, Lyon, France. 10. Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway. 11. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. 12. Department of Nutrition, Bjørknes University College, Oslo, Norway. 13. Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway. 14. Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy. 15. Epidemiology and Prevention Unit Fondazione IRCCS Istituto Nazionale dei Tumori Di Milano, Via Venezian, 1, 20133, Milano, Italy. 16. A.O.U. Federico II, Naples, Italy. 17. Dept. for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA, Bilthoven, The Netherlands. 18. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. 19. Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden. 20. Dept. of Radiation Sciences, Oncology Umeå University, Umeå, Sweden. 21. Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. 22. Institute of Nutritional Science, University of Potsdam, Potsdam, Germany. 23. Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixca, Murcia, Spain. 24. CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain. 25. Navarra Public Health Institute, Pamplona, Spain. 26. Navarra Institute for Health Research (IdiSNA), Pamplona, Spain. 27. CIBER Epidemiology and Public Health, CIBERESP, Madrid, Spain. 28. Unit of Cancer Epidemiology, Città Della Salute E Della Scienza University-Hospital, Via Santena 7, 10126, Turin, Italy. 29. Sub-Directorate for Public Health and Addictions of Gipuzkoa, Ministry of Health of the Basque Government, San Sebastián, Spain. 30. Epidemiology and Public Health Area, Biodonostia Health Research Institute, San Sebastián, Spain. 31. Cancer Registry and Histopathology Department, Provincial Health Authority (ASP 7), Ragusa, Italy. 32. Departamento de Nutrición Y Ciencias de los Alimentos, Universidad de Granada, Campus de Cartuja, 18071, Granada, Spain. 33. Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre, José Mataix', University of Granada, Granada, Spain. 34. Instituto de Investigación Biosanitaria de Granada (IBS GRANADA), Granada, Spain. 35. Danish Cancer Society Research Center, Diet, Genes and Environment, Nutrition and Biomarkers (NAB), Copenhagen, Denmark. 36. Universidad Paris-Saclay, UVSQ, Inserm, Gustave Roussy, Equipo "Exposome and Heredity", CESP, F-94805, Villejuif, France. 37. Departamento de Estadística, Informática Y Aplicaciones "G. Parenti" (DISIA), Universidad de Florencia, Florence, Italy. 38. Departamento de Pancreatología, Hospital Beaujon, AP-HP, Clichy, France. 39. Inserm UMR1149, Unidad DHU, Universidad Paris-Diderot, Paris, France. 40. Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Abstract
PURPOSE: There is existing evidence on the potential role of chronic inflammation in the pathogenesis of pancreatic cancer (PC) and on how risk may be modulated by dietary factors. Pro-inflammatory diets are suggested to be associated with increased risk of PC but, so far, evidence remains not conclusive. We examined the association between the dietary inflammatory potential and PC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which includes 450,112 participants. METHODS: After a 14-year follow-up, a total of 1239 incident PC cases were included in this study. The inflammatory potential of the diet was estimated using an Inflammatory Score of the Diet (ISD). Hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between the ISD and PC were estimated using multivariable Cox regression models, adjusted for known risk factors for PC. RESULTS: Participants with higher ISDs had a higher risk of developing PCs. In the fully adjusted multivariate model, the risk of PC increased by 11% (HR 1.11, 95% CI 1.02-1.22) for 1 point each standard deviation increase in the ISD score. Neither obesity nor any other known risk factor for PC showed statistically significant interactions. CONCLUSION: To the best of our knowledge, this is the first prospective study reporting a positive relationship between the inflammatory potential of diet and PC. Since early diagnosis and treatment of pancreatic cancer might be challenging, prevention remains the major hope for reducing the burden of this disease.
PURPOSE: There is existing evidence on the potential role of chronic inflammation in the pathogenesis of pancreatic cancer (PC) and on how risk may be modulated by dietary factors. Pro-inflammatory diets are suggested to be associated with increased risk of PC but, so far, evidence remains not conclusive. We examined the association between the dietary inflammatory potential and PC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which includes 450,112 participants. METHODS: After a 14-year follow-up, a total of 1239 incident PC cases were included in this study. The inflammatory potential of the diet was estimated using an Inflammatory Score of the Diet (ISD). Hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between the ISD and PC were estimated using multivariable Cox regression models, adjusted for known risk factors for PC. RESULTS: Participants with higher ISDs had a higher risk of developing PCs. In the fully adjusted multivariate model, the risk of PC increased by 11% (HR 1.11, 95% CI 1.02-1.22) for 1 point each standard deviation increase in the ISD score. Neither obesity nor any other known risk factor for PC showed statistically significant interactions. CONCLUSION: To the best of our knowledge, this is the first prospective study reporting a positive relationship between the inflammatory potential of diet and PC. Since early diagnosis and treatment of pancreatic cancer might be challenging, prevention remains the major hope for reducing the burden of this disease.
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Authors: Antonio Agudo; Valerie Cayssials; Catalina Bonet; Anne Tjønneland; Kim Overvad; Marie-Christine Boutron-Ruault; Aurélie Affret; Guy Fagherazzi; Verena Katzke; Ruth Schübel; Antonia Trichopoulou; Anna Karakatsani; Carlo La Vecchia; Domenico Palli; Sara Grioni; Rosario Tumino; Fulvio Ricceri; Salvatore Panico; Bas Bueno-de-Mesquita; Petra H Peeters; Elisabete Weiderpass; Guri Skeie; Theresa H Nøst; Cristina Lasheras; Miguel Rodríguez-Barranco; Pilar Amiano; María-Dolores Chirlaque; Eva Ardanaz; Bodil Ohlsson; Joana A Dias; Lena M Nilsson; Robin Myte; Kay-Tee Khaw; Aurora Perez-Cornago; Marc Gunter; Inge Huybrechts; Amanda J Cross; Kostas Tsilidis; Elio Riboli; Paula Jakszyn Journal: Am J Clin Nutr Date: 2018-04-01 Impact factor: 7.045
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