148 - THE ASSOCIATION OF DIABETES RELATED DIETARY PATTERNS WITH PANCREATIC CANCER RISK IN THE EPIC STUDY
Unit of Nutrition and Cancer, Catalan Institute of Oncology-Bellvitge Biomedical Research Institute; Department of Nutrition, Food Science and Gastronomy, Faculty of Pharmacy, University of Barcelona; School of Life Sciences, Technical University of Munich; Instituto de Salud Pública y Laboral de Navarra; Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for cancer research, prevention and clinical network; Paris-Saclay University, University of Versailles Saint Quentin, Inserm, Gustave Roussy, Centre for research in epidemiology and population health; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London; Department of Molecular Epidemiology, German Institute of Human Nutrition; Department of Epidemiology, Harvard T.H. Chan School of Public Health.
Background/Objectives: Pancreatic cancer remains one of the most lethal tumors. Its pathophysiology, detection and treatment are complex and not fully understood. Prevention remains as the most effective strategy to reduce disease burden. Evidence suggests that diabetes may play a role in its pathogenesis. We aimed to examine the association between dietary patterns related to diabetes and pancreatic cancer risk in a European population.
Methods: A total of 367,462 participants from the European Prospective Investigation into Cancer and Nutrition study (EPIC) were included. After a median follow-up of 15 years, 993 incident cases of pancreatic cancer were identified. After exclusions our sample included 926 cases. The Diabetes Risk Reduction Diet (DRRD), Empirical Dietary Index for Hyperinsulinemia (EDIH) and Empirical Dietary Index for Insulin Resistance (EDIR) were estimated from food frequency questionnaires. Hazard ratios and 95% confidence intervals for the association between dietary patterns and pancreatic cancer were calculated through Cox proportional hazards regression models.
Results: Pancreatic cancer cases had higher BMI in the range of overweight (mean 26.5 kg/m2, SD 4.3), consume more alcohol and were most likely current smokers. Higher adherence to DRRD showed a slightly lower risk of pancreatic cancer, although not statistically significance (HR T3 vs. T1 = 0.90, 95%CI 0.75-1.07). Higher adherence to EDIH was associated with a 21% increased pancreatic cancer risk (HR T3 vs. T1 = 1.21, 95%CI 1.02-1.44). No significant associations were observed for EDIR. Subgroup analysis indicated no heterogeneity across any of the subgroups analyzed.
Conclusions/Recommendations: Higher adherence to a dietary pattern associated with diabetes, a key etiological mechanism in pancreatic cancer, may contribute to the risk of developing this disease. Further research is warranted to elucidate the potential role of dietary factors related to diabetes and pancreatic cancer risk prevention.
