Lifestyle, body mass index, diabetes, and the risk of pancreatic cancer in a nationwide population-based cohort study with 7.4 million Korean subjects

• Published in: British journal of cancer Vol. 127; no. 3; pp. 549 - 557
• Main Authors: Park, Byung Kyu, Seo, Jeong Hun, Chung, Jae Bock, Choi, Jung Kyu
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.08.2022; Nature Publishing Group
• Subjects: 692/4028/67/1504/1713; 692/499; Biomedical and Life Sciences; Biomedicine; Body Mass Index; Cancer Research; Cohort analysis; Cohort Studies; Diabetes; Diabetes mellitus; Diabetes Mellitus - epidemiology; Drug Resistance; Epidemiology; Humans; Life Style; Molecular Medicine; Obesity; Obesity - complications; Obesity - epidemiology; Oncology; Pancreatic cancer; Pancreatic Neoplasms; Pancreatic Neoplasms - epidemiology; Pancreatic Neoplasms - etiology; Population studies; Population-based studies; Proportional Hazards Models; Republic of Korea - epidemiology; Risk Factors; Smoking; Republic of Korea
• ISSN: 0007-0920; 1532-1827; 1532-1827
• DOI: 10.1038/s41416-022-01807-5

Background Large-scale epidemiological studies on pancreatic cancer in non-Western populations are insufficient. We investigated the risk factors for pancreatic cancer. Methods Using the Korean National Health Insurance database, subjects who participated in the health examination program between 2005 and 2006 were identified and followed up until 2017. Adjusted hazard ratios (HRs) for pancreatic cancer risk were estimated using a Cox proportional hazards model. Results During 11.5 years follow-up, 22,543 of 7,445,947 participants were newly diagnosed with pancreatic cancer. Compared with normal-weight subjects, pancreatic cancer risk was increased in those with severe obesity (BMI ≥ 28 kg/m 2 ) (HR = 1.16; 95% CI, 1.11–1.23). Subjects with diabetes had an increased risk compared with those without diabetes (HR = 1.48; 95% CI, 1.43–1.53). Current smokers had a higher risk than never smokers (HR = 1.43; 95% CI, 1.38–1.48). Current smoking combined with diabetes increased the risk compared with never smokers without diabetes (HR = 2.13; 95% CI, 2.00–2.28). Current smoking combined with BMI ≥ 25 kg/m 2 had an increased risk compared with never smokers with BMI < 23 kg/m 2 (HR = 1.55; 95% CI, 1.46–1.65). Conclusion Smoking, obesity, and diabetes are significant risk factors for pancreatic cancer in Koreans. Lifestyle modifications for smoking and obesity would be beneficial for pancreatic cancer prevention.