Dietary patterns in relation to incidence rate of pancreatic cancer – the Norwegian women and cancer cohort study

Eliska  Selinger; Charlotta Rylander; Guri Skeie

doi:10.29219/fnr.v67.9536

Eliska Selinger Department of Epidemiology and Biostatistics, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic; and Centre for Public Health Promotion, National Institute of Public Health, Prague, Czech Republic
Charlotta Rylander Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
Guri Skeie Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway

DOI: https://doi.org/10.29219/fnr.v67.9536

Keywords: Pancreatic cancer, Dietary patterns, Women, Norway, Prospective cohort

Abstract

Despite development in cancer treatment and prevention options during the past few years, cancer of the pancreas remains a diagnosis associated with poor prognosis and limited options for prevention. Diet has proven to be an important risk factor for development of many types of cancer, particularly for cancers of the digestive system. Still, evidence regarding its relation to pancreatic cancer remains ambiguous. To investigate the relationship between diet and pancreatic cancer, an analysis of dietary patterns in participants from the Norwegian Women and Cancer Study (n = 89,156; 305 pancreatic cancer cases) was performed. Cox regression analysis was used for studying possible associations between dietary patterns, derived from principal component analysis, and pancreatic cancer incidence. The four most prominent dietary patterns were identified and described: European pattern, animal food consumers’ dietary pattern, traditional Norwegian pattern, and alcohol-abstaining dietary pattern. In analysis without adjustment for confounders, being in the highest tertile of the abstaining dietary pattern was associated with lower risk of pancreatic cancer in comparison to the lowest tertile (hazard ratios [HR]: 0.66, 95% confidence interval [CI]: 0.49–0.89). After additional adjustment for height and smoking status, no dietary pattern was associated with increased pancreatic cancer risk, nor was there any difference in effect estimates between strata of smokers and non-smokers. The results of our current analysis do not support the role of major dietary patterns in the development of pancreatic cancer.

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References

1.
Rawla P, Sunkara T, Gaduputi V. Epidemiology of pancreatic cancer: global trends, etiology and risk factors. World J Oncol 2019; 10(1): 10–27. doi: 10.14740%2Fwjon1166

2.
World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Expert Report 2018. Diet, nutrition, physical activity, and pancreatic cancer. [cited: 20 September 2023]. Available from: https://www.wcrf.org/sites/default/files/Pancreatic-cancer-report.pdf

3.
Mozaffarian D, Rosenberg I, Uauy R. History of modern nutrition science-implications for current research, dietary guidelines, and food policy. BMJ 2018; 361: k2392. doi: 10.1136/bmj.k2392

4.
Tapsell LC, Neale EP, Satija A, Hu FB. Foods, nutrients, and dietary patterns: interconnections and implications for dietary guidelines. Adv Nutr 2016; 7(3): 445–54. doi: 10.3945/an.115.011718

5.
McGuire S. Scientific Report of the 2015 Dietary Guidelines Advisory Committee. Washington, DC: US Departments of Agriculture and Health and Human Services, 2015. Adv Nutr 2016; 7: 202–4.

6.
Cespedes EM, Hu FB. Dietary patterns: from nutritional epidemiologic analysis to national guidelines. Am J Clin Nutr 2015; 101(5): 899–900. doi: 10.3945/ajcn.115.110213

7.
Zhao J, Li Z, Gao Q, et al. A review of statistical methods for dietary pattern analysis. Nutr J. 2021; 20(1): 37. doi: 10.1186%2Fs12937-021-00692-7

8.
DiBello JR, Kraft P, McGarvey ST, Goldberg R, Campos H, Baylin A. Comparison of 3 methods for identifying dietary patterns associated with risk of disease. Am J Epidemiol 2008; 168(12): 1433–43. doi: 10.1093%2Faje%2Fkwn274

9.
Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002 Feb; 13(1): 3–9. doi: 10.1097/00041433-200202000-00002

10.
Hu FB, Rimm E, Smith-Warner SA, Feskanich D, Stampfer MJ, Ascherio A, et al. Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire. Am J Clin Nutr 1999; 69(2): 243–9. doi: 10.1093/ajcn/69.2.243

11.
Hu FB, Rimm EB, Stampfer MJ, Ascherio A, Spiegelman D, Willett WC. Prospective study of major dietary patterns and risk of coronary heart disease in men. Am J Clin Nutr 2000; 72(4): 912–21. doi: 10.1093/ajcn/72.4.912

12.
Lund E, Dumeaux V, Braaten T, Hjartaker A, Engeset D, Skeie G, et al. Cohort profile: the Norwegian women and cancer study–NOWAC–Kvinner og kreft. Int J Epidemiol 2007; 37(1): 36–41. doi: 10.1093%2Fije%2Fdym137

13.
Lund E, Kumle M, Braaten T, Hjartåker A, Bakken K, Eggen E, et al. External validity in a population-based national prospective study – The Norwegian Women and Cancer Study (NOWAC). Cancer Causes Control 2003; 14(10): 1001–8. doi: 10.1023/b:caco.0000007982.18311.2e

14.
Parr CL, Veierød MB, Laake P, Lund E, Hjartåker A. Test-retest reproducibility of a food frequency questionnaire (FFQ) and estimated effects on disease risk in the Norwegian Women and Cancer Study (NOWAC). Nutr J 2006 Jan 31; 5: 4. doi: 10.1186/1475-2891-5-4

15.
Hjartåker A, Andersen LF, Lund E. Comparison of diet measures from a food-frequency questionnaire with measures from repeated 24-hour dietary recalls. The Norwegian Women and Cancer Study. Public Health Nutr 2007 Oct; 10(10): 1094–103. doi: 10.1017/S1368980007702872

16.
Hjartåker A, Lund E, Bjerve KS. Serum phospholipid fatty acid composition and habitual intake of marine foods registered by a semi-quantitative food frequency questionnaire. Eur J Clin Nutr 1997 Nov; 51(11): 736–42. doi: 10.1038/sj.ejcn.1600475

17.
Lachat C, Hawwash D, Ocké MC, Berg C, Forsum E, Hörnell A, et al. Strengthening the Reporting of Observational Studies in Epidemiology-Nutritional Epidemiology (STROBE-nut): an extension of the STROBE statement. PLoS Med 2016; 13(6): e1002036. doi: 10.1371%2Fjournal.pmed.1002036

18.
McCann SE, Marshall JR, Brasure JR, Graham S, Freudenheim JL. Analysis of patterns of food intake in nutritional epidemiology: food classification in principal components analysis and the subsequent impact on estimates for endometrial cancer. Public Health Nutr 2001; 4(5): 989–97. doi: 10.1079/phn2001168

19.
Lê S, Josse J, Husson F. FactoMineR: An R Package for Multivariate Analysis. J. Stat. Soft. 2008; 25(1): 1–18. doi: 10.18637%2Fjss.v025.i01

20.
Kassambara A, Mundt F. Factoextra: Extract and Visualize the Results of Multivariate Data Analyses. R Package Version 1.0.7. 2020. [cited: 20 September 2023]. Available from: https://CRAN.R-project.org/package=factoextra

21.
Therneau T, Lumley T. Package Survival: A Package for Survival Analysis in R. R Package. Version 2, 38. 2015. [cited: 20 September 2023]. Available from: https://CRAN.R-project.org/package=survival

22.
Bradbury KE, Appleby PN, Key TJ. Fruit, vegetable, and fiber intake in relation to cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Am J Clin Nutr 2014; 100 Suppl 1: 394S–8S. doi: 10.3945/ajcn.113.071357

23.
Naudin S, Viallon V, Hashim D, Freisling H, Jenab M, Weiderpass E, et al. Healthy lifestyle and the risk of pancreatic cancer in the EPIC study. Eur J Epidemiol 2020; 35(10): 975–86. doi: 10.1007/s10654-019-00559-6

24.
Zheng J, Guinter MA, Merchant AT, Wirth MD, Zhang J, Stolzenberg-Solomon RZ, et al. Dietary patterns and risk of pancreatic cancer: a systematic review. Nutr Rev 2017 Nov 1; 75(11): 883–908. doi: 10.1093/nutrit/nux0380

25.
Lu PY, Shu L, Shen SS, Chen XJ, Zhang XY. Dietary patterns and pancreatic cancer risk: a meta-analysis. Nutrients 2017; 9(1): 38. doi: 10.3390/nu9010038

26.
Gianfredi V, Ferrara P, Dinu M, Nardi M, Nucci D. Diets, dietary patterns, single foods and pancreatic cancer risk: an umbrella review of meta-analyses. Int J Environ Res Public Health 2022; 19(22): 14787. doi: 10.3390/ijerph192214787

27.
Oncina-Cánovas A, González-Palacios S, Notario-Barandiaran L, Torres-Collado L, Signes-Pastor A, de-Madaria E, et al. Adherence to pro-vegetarian food patterns and risk of oesophagus, stomach, and pancreas cancers: a multi case-control study (The PANESOES Study). Nutrients 2022; 14(24): 5288. doi: 10.3390/nu14245288

28.
Zhao Y, Zhan J, Wang Y, Wang D. The relationship between plant-based diet and risk of digestive system cancers: a meta-analysis based on 3,059,009 subjects. Front Public Health 2022; 10: 892153. doi: 10.3389/fpubh.2022.892153

29.
Roy A, Sahoo J, Kamalanathan S, Naik D, Mohan P, Kalayarasan R. Diabetes and pancreatic cancer: exploring the two-way traffic. World J Gastroenterol 2021; 27(30): 4939–62. doi: 10.3748/wjg.v27.i30.4939