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Body mass index and risk, age of onset, and survival in patients with pancreatic cancer
JAMA, 06/25/09

Li D et al. - In a study to demonstrate the association of excess body weight across an age cohort and the risk, age of onset, and overall survival (OS) of pts with pancreatic cancer (PC), it was shown that overweight or obesity during early adulthood was associated with a greater risk of PC and a younger age of disease onset. Obesity at an older age was associated with a lower OS in pts with PC.

Methods

A case-control study of 841 pts with pancreatic adenocarcinoma and 754 healthy individuals frequency matched by age, race, and sex.
Height and body weight histories were collected by personal interview starting at ages 14 to 19 yrs and over 10-yr intervals progressing to the yr prior to recruitment.
Associations between pts' body mass index (BMI) and risk of PC, age at onset, and OS were examined by unconditional logistic regression, linear regression, and Cox proportional hazard regression models, respectively.

Results

Individuals who were overweight (BMI of 25-29.9) from 14 to 39 yrs from the ages of 20 to 49 yrs had an associated increased risk of PC, independent of diabetes status.
The association was stronger in men by mean BMI from the ages of 14 to 59 yrs than in women and in ever smokers than in never smokers.
Population-attributable risk percentage of PC based on the mean BMI from the ages of 14 to 59 yrs was 10.3% for never smokers and 21.3% for ever smokers.
Individuals who were overweight or obese from the ages of 20 to 49 yrs had an earlier onset of PC by 2 to 6 yrs.
Compared with those with normal body weight and after adjusting for all clinical factors, individuals who were overweight or obese from the ages of 30 to 79 yrs or in the yr prior to recruitment had reduced OS of PC regardless of disease stage and tumor resection status.

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