CA Cancer J Clin 2001; 51:326
doi: 10.3322/canjclin.51.6.326
© 2001 American Cancer Society
OBESITY AND INACTIVITY INCREASE RISK OF PANCREATIC CANCER
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Weight loss and physical activity may help decrease pancreatic cancer risk.
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Obesity may increase the risk of pancreatic cancer, according to a report in JAMA (2001;286:921-929). But for those who are overweight, moderate physical activity of at least 90 minutes each week could reduce that risk considerably, the study authors report.
Pancreatic cancer is the fifth leading cause of cancer-related deaths in the US. Although it is well known that cigarette smoking increases the risk of pancreatic cancer, less is known about other modifiable risk factors.
Dominique Michaud, ScD, of the National Cancer Institute, and colleagues analyzed data from two large ongoing cohort studies to see to what degree a person’s body mass index and physical activity level might influence the risk of pancreatic cancer.
One of the studies, the Health Professionals Follow-up Study (started in 1986), included more than 46,000 male health professionals ages 40 to 75 years old. The second study, the Nurses’ Health Study (started in 1976), included about 117,000 female nurses ages 30 to 55.
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Weight Loss, Physical Activity May Help Decrease Pancreatic Cancer Risk
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After following the two cohorts for a 10-to-20 year period, investigators found 350 new cases of pancreatic cancer. Michaud and her colleagues determined that obese individuals were 72 percent more likely to be diagnosed with pancreatic cancer than those who were neither obese nor overweight. However, overweight and obese people who exercised moderately by regularly engaging in sustained activity, such as hiking or walking, were much less likely to develop pancreatic cancer compared with inactive people.
Obese and overweight individuals within the highest third of physical activity had a 41 percent lower risk of developing pancreatic cancer than individuals in the bottom third. In contrast, physical activity had no significant impact on pancreatic cancer risk for lean individuals, other than the potential value exercise has in maintaining a healthy body weight.
"Losing weight should be a priority for people who are obese—to reduce their risk of pancreatic cancer, as well as other important diseases," Michaud says. "In addition, engaging in moderate exercise may also help to lower the risk of pancreatic cancer among overweight and obese individuals."
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High Insulin Levels May Be the Cause
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Why obesity, physical inactivity, and pancreatic cancer are linked is still unclear, according to Michaud, but she speculates that abnormal glucose metabolism and high insulin levels may play a role in the development of pancreatic cancer.
In an editorial in the same journal Susan M. Gapstur, PhD, and Peter Gann, MD, of Northwestern University Medical School, note that cigarette smoking causes about 25 percent of all cases of pancreatic cancer. They estimate that obesity and inactivity could account for an additional 15 percent of cases.
According to Michael Thun, MD, Vice President of Epidemiology and Surveillance for the American Cancer Society, "Eliminating 40 percent of the estimated 28,900 deaths caused by pancreatic cancer would save 11,560 lives each year. And, eliminating these risk factors would have an even greater impact on several other cancers as well as on cardiovascular disease."
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Weight Loss, Physical Activity...
High Insulin Levels May...
