Skip to main content
SpringerLink
Log in

Obesity and Pancreatic Cancer

  • Chapter
  • First Online:
Obesity and Cancer

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 208))

Abstract

Pancreatic cancer has few known risk factors, providing little in the way of prevention, and is the most rapidly fatal cancer with 7 % survival rate at 5 years. Obesity has surfaced as an important risk factor for pancreatic cancer as epidemiological studies with strong methodological designs have removed important biases and solidified the obesity associations. Moreover, studies indicate that obesity early in adulthood is strongly associated with future risk of pancreatic cancer and that abdominal obesity is an independent risk factor. There is increasing evidence suggesting long-standing diabetes type 2 and insulin resistance are important etiological factors of this disease, providing a strong mechanistic link to obesity. The challenge remains to determine whether intended weight loss in midlife will reduce risk of pancreatic cancer and to elucidate the complex underlying pathways directly involved with risk.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. ACS (2015) Global cancer facts and figures, 3rd edn. American Cancer Society Inc, Atlanta

    Google Scholar 

  2. SEER (2015) SEER*Stat database: incidence—SEER 9 regs research data. National Cancer Institute. http://seer.cancer.gov/canques/incidence.html. Accessed 11 Nov 2015

  3. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. (2013) International agency for research on cancer. http://globocan.iarc.fr. Accessed 11 Nov 2015

  4. ACS (2015) Cancer facts and figures 2015. American Cancer Society Inc, Atlanta

    Google Scholar 

  5. World Cancer Research Fund, American Institute for Cancer Research (2007) Food, nutrition, physical activity, and the prevention of cancer: a global perspective. American Intitute for Cancer Research, Washington, D.C

    Google Scholar 

  6. IARC (2002) Weight control and physical activity, vol 6. IARC Handbooks of cancer prevention. IARC Press, Lyon

    Google Scholar 

  7. Yuan C, Bao Y, Wu C, Kraft P, Ogino S, Ng K, Qian ZR, Rubinson DA, Stampfer MJ, Giovannucci EL, Wolpin BM (2013) Prediagnostic body mass index and pancreatic cancer survival. Journal of clinical oncology (Official Journal of the American Society of Clinical Oncology) 31(33):4229–4234. doi:10.1200/JCO.2013.51.7532

    Article  Google Scholar 

  8. Aune D, Greenwood DC, Chan DS, Vieira R, Vieira AR, Navarro Rosenblatt DA, Cade JE, Burley VJ, Norat T (2012) Body mass index, abdominal fatness and pancreatic cancer risk: a systematic review and non-linear dose-response meta-analysis of prospective studies. Ann Oncol (Official Journal of the European Society for Medical Oncology/ESMO) 23(4):843–852. doi:10.1093/annonc/mdr398 (mdr398 [pii])

  9. Arslan AA, Helzlsouer KJ, Kooperberg C, Shu XO, Steplowski E, Bueno-de-Mesquita HB, Fuchs CS, Gross MD, Jacobs EJ, Lacroix AZ, Petersen GM, Stolzenberg-Solomon RZ, Zheng W, Albanes D, Amundadottir L, Bamlet WR, Barricarte A, Bingham SA, Boeing H, Boutron-Ruault MC, Buring JE, Chanock SJ, Clipp S, Gaziano JM, Giovannucci EL, Hankinson SE, Hartge P, Hoover RN, Hunter DJ, Hutchinson A, Jacobs KB, Kraft P, Lynch SM, Manjer J, Manson JE, McTiernan A, McWilliams RR, Mendelsohn JB, Michaud DS, Palli D, Rohan TE, Slimani N, Thomas G, Tjonneland A, Tobias GS, Trichopoulos D, Virtamo J, Wolpin BM, Yu K, Zeleniuch-Jacquotte A, Patel AV (2010) Anthropometric measures, body mass index, and pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium (PanScan). Arch Intern Med 170(9):791–802. doi:10.1001/archinternmed.2010.63 (170/9/791 [pii])

  10. Genkinger JM, Spiegelman D, Anderson KE, Bernstein L, van den Brandt PA, Calle EE, English DR, Folsom AR, Freudenheim JL, Fuchs CS, Giles GG, Giovannucci E, Horn-Ross PL, Larsson SC, Leitzmann M, Mannisto S, Marshall JR, Miller AB, Patel AV, Rohan TE, Stolzenberg-Solomon RZ, Verhage BA, Virtamo J, Willcox BJ, Wolk A, Ziegler RG, Smith-Warner SA (2011) A pooled analysis of 14 cohort studies of anthropometric factors and pancreatic cancer risk. Int J Cancer J int Cancer 129(7):1708–1717. doi:10.1002/ijc.25794

    Article  CAS  Google Scholar 

  11. Jiao L, Berrington de Gonzalez A, Hartge P, Pfeiffer RM, Park Y, Freedman DM, Gail MH, Alavanja MC, Albanes D, Beane Freeman LE, Chow WH, Huang WY, Hayes RB, Hoppin JA, Ji BT, Leitzmann MF, Linet MS, Meinhold CL, Schairer C, Schatzkin A, Virtamo J, Weinstein SJ, Zheng W, Stolzenberg-Solomon RZ (2010) Body mass index, effect modifiers, and risk of pancreatic cancer: a pooled study of seven prospective cohorts. Cancer Causes Control (CCC) 21(8):1305–1314. doi:10.1007/s10552-010-9558-x

    Article  Google Scholar 

  12. Bethea TN, Kitahara CM, Sonderman J, Patel AV, Harvey C, Knutsen SF, Park Y, Park SY, Fraser GE, Jacobs EJ, Purdue MP, Stolzenberg-Solomon RZ, Gillanders EM, Blot WJ, Palmer JR, Kolonel LN (2014) A pooled analysis of body mass index and pancreatic cancer mortality in african americans. Cancer Epidemiol Biomark Prev (A Publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology) 23(10):2119–2125. doi:10.1158/1055-9965.EPI-14-0422

    Article  CAS  Google Scholar 

  13. Lin Y, Fu R, Grant E, Chen Y, Lee JE, Gupta PC, Ramadas K, Inoue M, Tsugane S, Gao YT, Tamakoshi A, Shu XO, Ozasa K, Tsuji I, Kakizaki M, Tanaka H, Chen CJ, Yoo KY, Ahn YO, Ahsan H, Pednekar MS, Sauvaget C, Sasazuki S, Yang G, Xiang YB, Ohishi W, Watanabe T, Nishino Y, Matsuo K, You SL, Park SK, Kim DH, Parvez F, Rolland B, McLerran D, Sinha R, Boffetta P, Zheng W, Thornquist M, Feng Z, Kang D, Potter JD (2013) Association of body mass index and risk of death from pancreas cancer in Asians: findings from the Asia Cohort Consortium. Eur J Cancer Prev (The Official Journal of the European Cancer Prevention Organisation) 22(3):244–250. doi:10.1097/CEJ.0b013e3283592cef

    Article  Google Scholar 

  14. Parr CL, Batty GD, Lam TH, Barzi F, Fang X, Ho SC, Jee SH, Ansary-Moghaddam A, Jamrozik K, Ueshima H, Woodward M, Huxley RR (2010) Body-mass index and cancer mortality in the Asia-Pacific Cohort Studies Collaboration: pooled analyses of 424,519 participants. Lancet Oncol 11(8):741–752. doi:10.1016/S1470-2045(10)70141-8 (S1470-2045(10)70141-8 [pii])

  15. Genkinger JM, Kitahara CM, Bernstein L, Berrington de Gonzalez A, Brotzman M, Elena JW, Giles GG, Hartge P, Singh PN, Stolzenberg-Solomon RZ, Weiderpass E, Adami HO, Anderson KE, Beane-Freeman LE, Buring JE, Fraser GE, Fuchs CS, Gapstur SM, Gaziano JM, Helzlsouer KJ, Lacey JV Jr, Linet MS, Liu JJ, Park Y, Peters U, Purdue MP, Robien K, Schairer C, Sesso HD, Visvanathan K, White E, Wolk A, Wolpin BM, Zeleniuch-Jacquotte A, Jacobs EJ (2015) Central adiposity, obesity during early adulthood, and pancreatic cancer mortality in a pooled analysis of cohort studies. Ann Oncol (Official Journal of the European Society for Medical Oncology/ESMO) 26(11):2257–2266. doi:10.1093/annonc/mdv355

    Article  CAS  Google Scholar 

  16. Stolzenberg-Solomon RZ, Schairer C, Moore S, Hollenbeck A, Silverman DT (2013) Lifetime adiposity and risk of pancreatic cancer in the NIH-AARP diet and health study cohort. Am J Clin Nutr 98(4):1057–1065. doi:10.3945/ajcn.113.058123

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Patel AV, Rodriguez C, Bernstein L, Chao A, Thun MJ, Calle EE (2005) Obesity, recreational physical activity, and risk of pancreatic cancer in a large U.S. Cohort. Cancer Epidemiol Biomark Prev (A Publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology) 14(2):459–466. doi:10.1158/1055-9965.EPI-04-0583

    Article  Google Scholar 

  18. Isaksson B, Jonsson F, Pedersen NL, Larsson J, Feychting M, Permert J (2002) Lifestyle factors and pancreatic cancer risk: a cohort study from the Swedish Twin Registry. Int J Cancer J Int Cancer 98:480–482

    Article  CAS  Google Scholar 

  19. Olson SH, Chou JF, Ludwig E, O’Reilly E, Allen PJ, Jarnagin WR, Bayuga S, Simon J, Gonen M, Reisacher WR, Kurtz RC (2010) Allergies, obesity, other risk factors and survival from pancreatic cancer. Int J Cancer J Int Cancer 127(10):2412–2419. doi:10.1002/ijc.25240

    Article  CAS  Google Scholar 

  20. McWilliams RR, Matsumoto ME, Burch PA, Kim GP, Halfdanarson TR, de Andrade M, Reid-Lombardo K, Bamlet WR (2010) Obesity adversely affects survival in pancreatic cancer patients. Cancer 116(21):5054–5062. doi:10.1002/cncr.25465

    Article  PubMed  PubMed Central  Google Scholar 

  21. Li D, Morris JS, Liu J, Hassan MM, Day RS, Bondy ML, Abbruzzese JL (2009) Body mass index and risk, age of onset, and survival in patients with pancreatic cancer. JAMA 301(24):2553–2562. doi:10.1001/jama.2009.886

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Guan HB, Wu L, Wu QJ, Zhu J, Gong T (2014) Parity and pancreatic cancer risk: a dose-response meta-analysis of epidemiologic studies. PLoS ONE 9(3):e92738. doi:10.1371/journal.pone.0092738

    Article  PubMed  PubMed Central  Google Scholar 

  23. Lee E, Horn-Ross PL, Rull RP, Neuhausen SL, Anton-Culver H, Ursin G, Henderson KD, Bernstein L (2013) Reproductive factors, exogenous hormones, and pancreatic cancer risk in the CTS. Am J Epidemiol 178(9):1403–1413. doi:10.1093/aje/kwt154

    Article  PubMed  PubMed Central  Google Scholar 

  24. Huxley R, Ansary-Moghaddam A, Berrington de Gonzalez A, Barzi F, Woodward M (2005) Type-II diabetes and pancreatic cancer: a meta-analysis of 36 studies. Br J Cancer 92(11):2076–2083

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. International Expert C (2009) International expert committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care 32(7):1327–1334. doi:10.2337/dc09-9033

    Article  Google Scholar 

  26. Grote VA, Rohrmann S, Nieters A, Dossus L, Tjonneland A, Halkjaer J, Overvad K, Fagherazzi G, Boutron-Ruault MC, Morois S, Teucher B, Becker S, Sluik D, Boeing H, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Pala V, Tumino R, Vineis P, Panico S, Rodriguez L, Duell EJ, Molina-Montes E, Dorronsoro M, Huerta JM, Ardanaz E, Jeurnink SM, Beulens JW, Peeters PH, Sund M, Ye W, Lindkvist B, Johansen D, Khaw KT, Wareham N, Allen N, Crowe F, Jenab M, Romieu I, Michaud DS, Riboli E, Romaguera D, Bueno-de-Mesquita HB, Kaaks R (2011) Diabetes mellitus, glycated haemoglobin and C-peptide levels in relation to pancreatic cancer risk: a study within the European prospective investigation into cancer and nutrition (EPIC) cohort. Diabetologia 54(12):3037–3046. doi:10.1007/s00125-011-2316-0

    Article  CAS  PubMed  Google Scholar 

  27. Wolpin BM, Bao Y, Qian ZR, Wu C, Kraft P, Ogino S, Stampfer MJ, Sato K, Ma J, Buring JE, Sesso HD, Lee IM, Gaziano JM, McTiernan A, Phillips LS, Cochrane BB, Pollak MN, Manson JE, Giovannucci EL, Fuchs CS (2013) Hyperglycemia, insulin resistance, impaired pancreatic beta-cell function, and risk of pancreatic cancer. J Natl Cancer Inst 105(14):1027–1035. doi:10.1093/jnci/djt123

    Article  PubMed  PubMed Central  Google Scholar 

  28. Batty GD, Shipley MJ, Marmot M, Smith GD (2004) Diabetes status and post-load plasma glucose concentration in relation to site-specific cancer mortality: findings from the original Whitehall study. Cancer Causes Control (CCC) 15(9):873–881. doi:10.1007/s10552-004-1050-z

    Article  Google Scholar 

  29. Jee SH, Ohrr H, Sull JW, Yun JE, Ji M, Samet JM (2005) Fasting serum glucose level and cancer risk in Korean men and women. JAMA 293(2):194–202. doi:10.1001/jama.293.2.194

    Article  CAS  PubMed  Google Scholar 

  30. Stolzenberg-Solomon RZ, Graubard BI, Chari S, Limburg P, Taylor PR, Virtamo J, Albanes D (2005) Insulin, glucose, insulin resistance, and pancreatic cancer in male smokers. JAMA 294(22):2872–2878. doi:10.1001/jama.294.22.2872

    Article  CAS  PubMed  Google Scholar 

  31. Gapstur SM, Gann PH, Lowe W, Liu K, Colangelo L, Dyer A (2000) Abnormal glucose metabolism and pancreatic cancer mortality. JAMA 283(19):2552–2558

    Article  CAS  PubMed  Google Scholar 

  32. Johansen D, Stocks T, Jonsson H, Lindkvist B, Bjorge T, Concin H, Almquist M, Haggstrom C, Engeland A, Ulmer H, Hallmans G, Selmer R, Nagel G, Tretli S, Stattin P, Manjer J (2010) Metabolic factors and the risk of pancreatic cancer: a prospective analysis of almost 580,000 men and women in the metabolic syndrome and cancer project. Cancer Epidemiol Biomark Prev (A Publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology) 19(9):2307–2317. doi:10.1158/1055-9965.EPI-10-0234

    Article  CAS  Google Scholar 

  33. Michaud DS, Wolpin B, Giovannucci E, Liu S, Cochrane B, Manson JE, Pollak MN, Ma J, Fuchs CS (2007) Prediagnostic plasma C-peptide and pancreatic cancer risk in men and women. Cancer Epidemiol Biomark Prev (A Publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology) 16(10):2101–2109. doi:10.1158/1055-9965.EPI-07-0182 (1055-9965.EPI-07-0182 [pii])

  34. Malaguarnera R, Sacco A, Voci C, Pandini G, Vigneri R, Belfiore A (2012) Proinsulin binds with high affinity the insulin receptor isoform A and predominantly activates the mitogenic pathway. Endocrinology 153(5):2152–2163. doi:10.1210/en.2011-1843

    Article  CAS  PubMed  Google Scholar 

  35. Fantuzzi G (2005) Adipose tissue, adipokines, and inflammation. J Allergy Clin Immunol 115(5):911–919; quiz 920. doi:10.1016/j.jaci.2005.02.023

    Google Scholar 

  36. Greer JB, Whitcomb DC (2009) Inflammation and pancreatic cancer: an evidence-based review. Curr Opin Pharmacol 9(4):411–418. doi:10.1016/j.coph.2009.06.011 (S1471-4892(09)00084-8 [pii])

  37. Duell EJ, Lucenteforte E, Olson SH, Bracci PM, Li D, Risch HA, Silverman DT, Ji BT, Gallinger S, Holly EA, Fontham EH, Maisonneuve P, Bueno-de-Mesquita HB, Ghadirian P, Kurtz RC, Ludwig E, Yu H, Lowenfels AB, Seminara D, Petersen GM, La Vecchia C, Boffetta P (2012) Pancreatitis and pancreatic cancer risk: a pooled analysis in the International pancreatic cancer case-control consortium (PanC4). Ann Oncol (Official Journal of the European Society for Medical Oncology/ESMO) 23(11):2964–2970. doi:10.1093/annonc/mds140 (mds140 [pii])

  38. Douglas JB, Silverman DT, Weinstein SJ, Graubard BI, Pollak MN, Tao Y, Virtamo J, Albanes D, Stolzenberg-Solomon RZ (2011) Serum C-reactive protein and risk of pancreatic cancer in two nested, case-control studies. Cancer Epidemiol Biomark Prev (A Publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology) 20(2):359–369. doi:10.1158/1055-9965.EPI-10-1024

    Article  CAS  Google Scholar 

  39. Grote VA, Kaaks R, Nieters A, Tjonneland A, Halkjaer J, Overvad K, Skjelbo Nielsen MR, Boutron-Ruault MC, Clavel-Chapelon F, Racine A, Teucher B, Becker S, Pischon T, Boeing H, Trichopoulou A, Cassapa C, Stratigakou V, Palli D, Krogh V, Tumino R, Vineis P, Panico S, Rodriguez L, Duell EJ, Sanchez MJ, Dorronsoro M, Navarro C, Gurrea AB, Siersema PD, Peeters PH, Ye W, Sund M, Lindkvist B, Johansen D, Khaw KT, Wareham N, Allen NE, Travis RC, Fedirko V, Jenab M, Michaud DS, Chuang SC, Romaguera D, Bueno-de-Mesquita HB, Rohrmann S (2012) Inflammation marker and risk of pancreatic cancer: a nested case-control study within the EPIC cohort. Br J Cancer 106(11):1866–1874. doi:10.1038/bjc.2012.172 (bjc2012172 [pii])

    Google Scholar 

  40. Bao Y, Giovannucci EL, Kraft P, Qian ZR, Wu C, Ogino S, Gaziano JM, Stampfer MJ, Ma J, Buring JE, Sesso HD, Lee IM, Rifai N, Pollak MN, Jiao L, Lessin L, Cochrane BB, Manson JE, Fuchs CS, Wolpin BM (2013) Inflammatory plasma markers and pancreatic cancer risk: a prospective study of five U.S. cohorts. Cancer Epidemiol Biomark Prev (A Publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology) 22(5):855–861. doi:10.1158/1055-9965.EPI-12-1458

    Article  CAS  Google Scholar 

  41. Dixit VD (2008) Adipose-immune interactions during obesity and caloric restriction: reciprocal mechanisms regulating immunity and health span. J Leukoc Biol 84(4):882–892. doi:10.1189/jlb.0108028

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Sell H, Eckel J (2010) Adipose tissue inflammation: novel insight into the role of macrophages and lymphocytes. Curr Opin Clin Nutr Metab Care 13(4):366–370. doi:10.1097/MCO.0b013e32833aab7f

    Article  PubMed  Google Scholar 

  43. Milner JJ, Beck MA (2012) The impact of obesity on the immune response to infection. Proc Nutr Soc 71(2):298–306. doi:10.1017/S0029665112000158

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Michaud DS, Houseman EA, Marsit CJ, Nelson HH, Wiencke J, Kelsey KT (2015) Understanding the role of the immune system in cancer: new opportunities for population-based research. Cancer Epidemiol Biomark Prev (A Publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology). doi:10.1158/1055-9965.EPI-15-0681

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA

    Dominique S. Michaud

Authors
  1. Dominique S. Michaud
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dominique S. Michaud .

Editor information

Editors and Affiliations

  1. Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Robert-Rössle-Straße , Berlin, Germany

    Tobias Pischon

  2. Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Robert-Rössle-Straße, Berlin, Germany

    Katharina Nimptsch

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Michaud, D.S. (2016). Obesity and Pancreatic Cancer. In: Pischon, T., Nimptsch, K. (eds) Obesity and Cancer. Recent Results in Cancer Research, vol 208. Springer, Cham. https://doi.org/10.1007/978-3-319-42542-9_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-42542-9_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-42540-5

  • Online ISBN: 978-3-319-42542-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation