The effect of modifiable risk factors on pancreatic cancer mortality in populations of the Asia-Pacific region

Alireza Ansary-Moghaddam, Rachel Huxley, Federica Barzi, Carlene Lawes, Takayoshi Ohkubo, Xianghua Fang, Sun Ha Jee, Mark Woodward, A. Okayama, H. Ueshima, H. Maegawa, N. Aoki, M. Nakamura, N. Kubo, T. Yamada, Z. S. Wu, C. H. Yao, G. Andrews, T. A. Welborn, Z. TangL. S. Liu, J. X. Xie, R. Norton, S. Ameratunga, S. MacMahon, G. Whitlock, M. W. Knuiman, H. Christensen, J. Zhou, X. H. Yu, X. G. Wu, A. Tamakoshi, W. H. Pan, P. Sritara, Z. L. Wu, L. Q. Chen, G. L. Shan, D. F. Gu, X. F. Duan, R. Jackson, Y. H. Li, T. H. Lam, C. Q. Jiang, M. Fujishima, Y. Kiyohara, H. Iwamoto, J. Woo, S. C. Ho, Z. Hong, M. S. Huang, B. Zhou, J. L. Fuh, Y. Kita, S. R. Choudhury, I. Suh, I. S. Kim, G. Giles, T. Hashimoto, K. Sakata, A. Dobson, Y. Imai, A. Hozawa, K. Jamrozik, M. Hobbs, R. Broadhurst, K. Nakachi, X. H. Fang, S. C. Li, Q. D. Yang, Z. M. Chen, H. Tanaka, A. Nozaki, H. Horibe, Y. Matsutani, M. Kagaya, K. Hughes, J. Lee, D. Heng, S. K. Chew, B. F. Zhou, H. Y. Zhang, K. Shimamoto, S. Saitoh, Z. Z. Li, P. Norman, Y. He, S. X. Yao

Research output: Contribution to journalArticlepeer-review

82 Citations (Scopus)


Background: Pancreatic cancer accounts for about 220,000 deaths each year. Known risk factors are smoking and type 2 diabetes. It remains to be seen whether these risk factors are equally important in Asia and whether other modifiable risk factors have important associations with pancreatic cancer. Methods: An individual participant data analysis of 30 cohort studies was carried out, involving 420,310 Asian participants (33% female) and 99,333 from Australia/New Zealand (45% female). Cox proportional hazard models, stratified by study and sex and adjusted for age, were used to quantify risk factors for death from pancreatic cancer. Results: During 3,558,733 person-years of follow-up, there were 324 deaths from pancreatic cancer (54% Asia and 33% female). Mortality rates (per 100,000 person-years) from pancreatic cancer were 10 for men and 8 for women. The following are age-adjusted hazard ratios (95% confidence interval) for death from pancreatic cancer: for current smoking, 1.61 (1.12-2.32); for diabetes, 1.76 (1.15-2.69); for a 2-cm increase in waist circumference, 1.08 (1.02-1.14). All three relationships remained significant (P < 0.05) after adjustment for other risk factors. There was no evidence of heterogeneity in the strength of these associations between either cohorts from Asia and Australia/New Zealand or between the sexes. In men, the combination of cigarette smoking and diabetes more than doubled the likelihood of pancreatic cancer (2.47; 95% confidence interval, 1.17-5.21) in both regions. Conclusions: Smoking, obesity, and diabetes are important and are potentially modifiable risk factors for pancreatic cancer in populations of the Asia-Pacific region. Activities to prevent them can be expected to lead to a major reduction in the number of deaths from this cancer, particularly in Asia with its enormous population.

Original languageEnglish
Pages (from-to)2435-2440
Number of pages6
JournalCancer Epidemiology Biomarkers and Prevention
Issue number12
Publication statusPublished - 2006 Dec


Dive into the research topics of 'The effect of modifiable risk factors on pancreatic cancer mortality in populations of the Asia-Pacific region'. Together they form a unique fingerprint.

Cite this