Vegetables and pancreatic cancer.
Pancreatic cancer risk: Data about total vegetables was provided by 7 cohorts, including a total of 2,678 cases.
No (non)significant associations were found. The average RR = 0.93.
Inclusion of intermediate levels of consumption:
Data from one cohort (16) could not be used in the following table, because RRs were presented in g/1000 kcal/d. Since men and women consume different amounts
of calories, no translation can be made to g/day.
(Non)significant effects at any level of consumption were restricted to findings from one cohort (George SM [17]). A significant protective effect was found at the level of
consumption of 243-320 g/day among women. Noticeable is the fact that no RR was above 1 at the approximate level of recommended daily intakes: 193-262 g/day
(2.5-3.4 servings/day).
Pancreatic cancer mortality: Data about total vegetables was provided by 3 cohorts, including a total of 3,629 cases.
A nonsignificant protective effect was found in one cohort, among men (5). No other associations were found. The average RR = 0.89 (excluding incomplete data from
Zhang W [3]).
Conclusion: No significant association was found in any cohort. No evidence was found for an association between total vegetables and pancreatic cancer risk,
or pancreatic cancer death.
| Author | Cohort name | Cases | Relative Risk (RR) |
|---|---|---|---|
| 18) Vrieling A (2009) | The EPIC Study | 555 | HR = 0.99 (0.73-1.33; P = 0.94) |
| 17) George SM (2008) | The NIH-AARP Diet and Health Study | Men: 713. Women: 377. | Men: RR = 1.03 (0.81-1.32; P = 0.243). Women: RR = 0.82 (0.59-1.13; P = 0.159) |
| 16) Nöthlings U (2007) | The Multiethnic Cohort Study | 529 | HR = 0.86 (0.65-1.14; P = 0.134) |
| 14) Larsson SC (2006) | The Swedish Mammography Cohort & The Cohort of Swedish Men | 135 | HR = 1.08 (0.63-1.85; P = 0.87) |
| 6) Bobe G (2008) | The ATBC Study | 306 | HR = 0.78 (0.54-1.12; P = 0.37) |
| 4) Shibata A (1994) | The Leisure World Study | 63 | RR = 0.82 (0.44-1.51) |
| Total number of cases: 2,678 | Average RR = 0.93 |
| Author | Cohort name | Cases | Relative Risk (RR) |
|---|---|---|---|
| 15) Lin Y (2006) | The JACC Study | Men: 119. Women: 129. | Men: HR = 0.64 (0.38-1.09; P = 0.13). Women: HR = 0.90 (0.55-1.48; P = 0.96). |
| 5) Couglin SS (2000) | The Cancer Prevention Study II | Men: 1,787. Women: 1,538. | Men: RR = 0.9 (0.8-1.0). Women: RR = 0.9 (0.8-1.1). |
| 3) Zhang W (1993) | The Lutheran Brotherhood Cohort | 56 | No clear association. |
| Total number of cases: 3,629 | Average RR = 0.89 |
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 18) Vrieling A (2009) | The EPIC Study | 478,400 subjects from 10 European countries. | 8.9 (1991-2000 to 2002-2007) | 555 | Invasive exocrine pancreatic cancer incidence | Total vegetables (excluding legumes, potatoes, and other tubers) |
HR = 0.99 (0.73-1.33; P = 0.94) for the highest vs lowest quartile of consumption. Amount specific data (g/day): < 110: HR = 1. 110-175: HR = 0.98 (0.77-1.24). 175-276: HR = 0.93 (0.72-1.21). > 276: HR = 0.99 (0.73-1.33). | Stratified by age at entry, sex and center. Adjusted for energy from fat, energy from non-fat, weight, height, history of diabetes, and smoking status. Waist-to-hip ratio, alcohol, red meat and processed meat intake, and education did not markedly change the risk estimates. |
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| 17) George SM (2008) | The National Institutes of Health-AARP Diet and Health Study. | 195,229 women and 288,109 men aged 50-71. (USA) | 1995-2003 | 377 women, and 713 men | Pancreas cancer incidence | Vegetables (excluding potatoes) |
1 cup = 237 mL. One cup is 1 cup of raw/cooked vegetable, 1 cup of 100% juice, or 2 cups of raw leafy greens. Age, smoking (smoking status, time since quitting, and smoking dose), energy intake, BMI, alcohol, physical activity, education , race, marital status, family history, menopausal hormone therapy (women), and fruit intake. |
16) Nöthlings U (2007) | The Multiethnic Cohort Study | 183,522 men and women aged 45-75. | (Hawaii-Los Angeles) 8.3 | (1993-96 to 2002) 529 | Exocrine pancreatic cancer incidence | Total vegetables (Includes potatoes and other tubers; legumes; tomatoes; light green, dark green, cruciferous, and yellow vegetables; corn; and other vegetables (e.g., onions, garlic, seaweed, sprouts, eggplant, mushrooms) |
RR = 0.86 (0.54-1.14; P = 0.134) for the highest vs lowest quintile of consumption. | Amount specific data (g/1,000 kcal/day): 78.14: RR = 1. 115.56: RR = 0.99 (0.76-1.28). 147.96: RR = 1.00 (0.77-1.30). 187.54: RR = 0.79 (0.59-1.04). 266.28: RR = 0.86 (0.65-1.14).
No differences in effects of vegetables on risk were found, stratified by processed meat intake. Sex and time in the study were adjusted for as strata variables. Further adjustment was made for age at cohort entry, ethnicity, history of diabetes mellitus, family history of pancreatic cancer, smoking status, pack-years of smoking, intakes of red meat and processed meat, energy intake, and body mass index. |
14) Larsson SC (2006) | The Swedish Mammography Cohort | & The Cohort of Swedish Men 81,922 subjects (36,616 women and 45,306 men). | 6.8 | (1998-2004) 135 | (61 women and 74 men) Primary malignant neoplasm of the exocrine pancreas incidence | All vegetables (spinach, iceberg lettuce, leafy salad, tomato, tomato juice, carrots, beets, cabbage, broccoli, Brussels sprouts, cauliflower, kale, pepper, green peas, onion, leek, garlic, and mixed vegetables. | Not including potatoes, beans, and lentils)
HR = 1.08 (0.63-1.85; P = 0.87) for the highest vs lowest quartile of consumption. | Amount specific data (servings/d): < 1.5: HR = 1. 1.5-2.4: HR = 1.03 (0.64-1.67). 2.5-3.4: HR = 0.72 (0.40-1.30). ≥ 3.5: HR = 1.08 (0.63-1.85). Age, sex, education, BMI, physical activity, cigarette smoking status and pack-years of smoking, multivitamin supplement use, and intakes of total energy, alcohol, and all fruits. |
6) Bobe G (2008) | The Alpha-Tocopherol, beta-Carotene Cancer Prevention Study (ATBC) | 27,111 healthy male smokers of ≥ 5 cigarettes/day aged 50-69. | (Finland) 16.1 | (1985-2004) 306 | Primary exocrine adenocarcinoma of the pancreas incidence | Vegetables (not defined) |
HR = 0.78 (0.54-1.12; P = 0.37) for the highest vs lowest quintile of consumption. | Amount specific data (g/day): ≤ 208.3: HR = 1. 208.3-258.2: HR = 0.81 (0.57-1.15). > 258.2-307.2: HR = 0.81 (0.57-1.16). > 307.2-373.0: HR = 0.95 (0.67-1.33). > 373.0: HR = 0.78 (0.54-1.12). Effect modification: No significant interaction was found by intervention (any supplement [alpha-tocopherol, beta-carotene, or both] vs placebo). Age at randomization, years of smoking, total number of cigarettes per day, self-reported history of diabetes mellitus, and energy-adjusted saturated fat intake. |
6) Stolzenberg-Solomon RZ (2002) | The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC). | 27,111 male smokers of ≥ 5 cigarettes/day aged 50-69. | (Finland) 13 | (1985-88 to 1997) 163? | Primary malignant neoplasm of the exocrine pancreas incidence | Vegetables (not defined) |
HR = 0.77 (0.47-1.27; P = 0.32) for the highest vs lowest quintile of consumption. | Amount specific data (g/day): ≤ 52.9: HR = 1. > 52.9 and ≤ 79.9: HR = 0.92 (0.58-1.48). > 79.9 and ≤ 110.1: HR = 0.97 (0.61-1.55). > 110.1 and ≤ 153.7: HR = 0.89 (0.55-1.44). > 153.7: HR = 0.77 (0.47-1.27). Energy intake, age and years of smoking. |
Additional variables examined in the analyses included ATBC trial interventions; dietary folate, saturated fat, and carbohydrate intakes; history of diabetes mellitus; occupational physical activity; and education. 6) Stolzenberg-Solomon RZ (2002) | The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC). | 27,111 male smokers of ≥ 5 cigarettes/day aged 50-69. | (Finland) 13 | (1985-88 to 1997) 163? | Primary malignant neoplasm of the exocrine pancreas incidence | Fresh vegetables (not defined) |
HR = 0.96 (0.59-1.55; P = 0.41) for the highest vs lowest quintile of consumption. | Amount specific data (g/day): ≤ 13.7: HR = 1. > 13.7 and ≤ 27.3: HR = 1.09 (0.69-1.72). > 27.3 and ≤ 44.8: HR = 1.02 (0.64-1.64). > 44.8 and ≤ 74.3: HR = 0.68 (0.40-1.15). > 74.3: HR = 0.96 (0.59-1.55). Energy intake, age and years of smoking. |
Additional variables examined in the analyses included ATBC trial interventions; dietary folate, saturated fat, and carbohydrate intakes; history of diabetes mellitus; occupational physical activity; and education. 6) Stolzenberg-Solomon RZ (2002) | The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC). | 27,111 male smokers of ≥ 5 cigarettes/day aged 50-69. | (Finland) 13 | (1985-88 to 1997) 163? | Primary malignant neoplasm of the exocrine pancreas incidence | Vegetables and legumes (not defined) |
HR = 0.72 (0.43-1.19; P = 0.29) for the highest vs lowest quintile of consumption. | Amount specific data (g/day): ≤ 56.8: HR = 1. > 56.8 and ≤ 84.3: HR = 0.84 (0.52-1.36). > 84.3 and ≤ 115.4: HR = 0.97 (0.61-1.54). > 115.4 and ≤ 160.3: HR = 0.90 (0.56-1.44). > 160.3: HR = 0.72 (0.43-1.19). Energy intake, age and years of smoking. |
Additional variables examined in the analyses included ATBC trial interventions; dietary folate, saturated fat, and carbohydrate intakes; history of diabetes mellitus; occupational physical activity; and education. 4) Shibata A (1994) | The Leisure World Study | 13,979 residents of a retirement community. | 9 | (1981-1990) 63 | Pancreatic cancer incidence | Vegetables (not defined) |
RR = 0.82 (0.44-1.51) for the highest vs lowest tertile of consumption. | Amount specific data (servings per day): < 3.2: RR = 1. 3.2-4.6: RR = 0.96 (0.53-1.72). ≥ 4.7: RR = 0.82 (0.44-1.51). Sex, age and cigarette smoking. |
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