Adult Changes in Weight and Physical Activity in Association with the Risk of Pancreatic Cancer: In the Vital Cohort Public Deposited

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  • March 21, 2019
Creator
  • Samai, Peter
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
Abstract
  • Significance. Pancreatic cancer is the fourth most common cancer-related death in the United States (U.S.); by 2030 this lethal disease is projected to be the second leading cause of cancer-related mortality. Thus, identifying modifiable risk factors for pancreatic cancer is of public health importance. Innovation. Two modifiable factors that impact pancreatic cancer are obesity and, perhaps, physical activity. Obesity is among the few risk factors that have been consistently associated with pancreatic cancer incidence, whereas the association with physical activity is inconsistent. However, whether age-specific exposures, or adult changes in exposure, are associated with pancreatic cancer is unclear for both exposures. Identification of age-specific risk factors, or adult changes in exposure, could lead to age-specific targeted prevention strategies. Dissertation Goals. My hypothesis was that age-specific weight and physical activity, and perhaps adult changes, may modulate pancreatic cancer risk. These exposures could plausibly act through several biologic mechanisms, including influencing circulating endogenous hormones, which may in turn impact pancreatic carcinogenesis. Thus, my objectives were to prospectively examine the associations of age-specific weight and physical activity, and adult changes, with pancreatic cancer risk. Methods. I used the National Cancer Institute-funded VITamins And Lifestyle (VITAL) study. This cohort of ~77,000 men and women in Washington state was recruited in 2000-2002, when participants were aged 55-76 years. Data collection included assessment of baseline, age-specific, and changes in adult weight and physical activity. Incident pancreatic cancer events (n=280) were identified through linkage to state and national registries after ~10 years of follow-up. Multi-variable Cox proportional hazards models were used to obtain estimates for the pancreatic cancer risk associations. Results. Pancreatic cancer risk was reduced by ~30-40% in association with adult physical activity undertaken in the 10 years prior to study recruitment, and with physical activity undertaken most days of the week during mid-life. In addition, mid-life adult obesity and weight gain, were associated with ~30-80% elevation in pancreatic cancer risk. Study Impact. If my results are replicated, targeting middle-aged adult Americans to engage in physical activity most days of the week, and avoid weight gain may be possible risk reduction strategies for this lethal cancer.
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Rights statement
  • In Copyright
Advisor
  • Bradshaw, Patrick
  • Olshan, Andrew
  • Gammon, Marilie D.
  • Robinson, Whitney
  • Sanoff, Hanna
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2017
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