Skip to main content
Erschienen in: Cancer Causes & Control 3/2007

01.04.2007 | Original Paper

Glycemic load, glycemic index, and carbohydrate intake in relation to pancreatic cancer risk in a large US cohort

verfasst von: Alpa V. Patel, Marjorie L. McCullough, Alexandre L. Pavluck, Eric J. Jacobs, Michael J. Thun, Eugenia E. Calle

Erschienen in: Cancer Causes & Control | Ausgabe 3/2007

Einloggen, um Zugang zu erhalten

Abstract

Background

Consumption of diets with high glycemic load has been hypothesized to increase pancreatic cancer risk by raising postprandial glucose levels and insulin secretion.

Methods

The authors analyzed data from the American Cancer Society Cancer Prevention Study II (CPS-II) Nutrition Cohort to examine the association between pancreatic cancer and glycemic load, glycemic index (GI), and intake of carbohydrates. Diet was assessed among 124,907 men and women who were cancer-free and non-diabetic at baseline in 1992 using a validated 68-item food frequency questionnaire (FFQ). During 9 years of follow-up, 401 incident pancreatic cancer cases were identified. Cox proportional hazards modeling was used to compute hazard rate ratios (RR) adjusted for potential confounding factors.

Results

We found no association between glycemic load, GI, or carbohydrate intake and risk of pancreatic cancer in this population. The hazard rate ratio (RR) was 1.01 (95% CI 0.75–1.37, trend P = 0.80) for glycemic load, 0.92 (95% CI 0.68–1.24) for GI, and 1.10 (95% CI 0.80–1.51) for carbohydrate intake among men and women in the highest quintile compared to the lowest quintile of each measure. We also found no significant association between these measures and pancreatic cancer risk among individuals who show a greater susceptibility towards insulin insensitivity, such as those who are overweight or more sedentary.

Conclusion

Overall, our data do not support the hypothesis that glycemic load or index, or carbohydrate intake are associated with a substantial increase in pancreatic cancer risk; however, a weak positive association cannot be ruled out.
Literatur
1.
Zurück zum Zitat American Cancer Society (2006) Cancer Facts & Figures. Atlanta, GA: American Cancer Society American Cancer Society (2006) Cancer Facts & Figures. Atlanta, GA: American Cancer Society
2.
Zurück zum Zitat Calle EE, Murphy TK, Rodriguez C, Thun MJ, Jr. CWH (1998) Diabetes mellitus and pancreatic cancer mortality in a prospective cohort of United States adults. Cancer Causes Control 9:403–410PubMedCrossRef Calle EE, Murphy TK, Rodriguez C, Thun MJ, Jr. CWH (1998) Diabetes mellitus and pancreatic cancer mortality in a prospective cohort of United States adults. Cancer Causes Control 9:403–410PubMedCrossRef
3.
Zurück zum Zitat Coughlin SS, Calle EE, Patel AV, Thun MJ (2000) Predictors of pancreatic cancer mortality among a large cohort of United States adults. Cancer Causes Control 11:915–923PubMedCrossRef Coughlin SS, Calle EE, Patel AV, Thun MJ (2000) Predictors of pancreatic cancer mortality among a large cohort of United States adults. Cancer Causes Control 11:915–923PubMedCrossRef
4.
Zurück zum Zitat Everhart J, Wright D (1995) Diabetes mellitus as a risk factor for pancreatic cancer. JAMA 273:1605–1609PubMedCrossRef Everhart J, Wright D (1995) Diabetes mellitus as a risk factor for pancreatic cancer. JAMA 273:1605–1609PubMedCrossRef
5.
Zurück zum Zitat IARC (2002) IARC handbooks on cancer prevention: weight control and physical activity. Lyon: IARC Press IARC (2002) IARC handbooks on cancer prevention: weight control and physical activity. Lyon: IARC Press
6.
Zurück zum Zitat Lund-Nilsen TI, Vateen LJ (2000) A prospective study of lifestyle factors and the risk of pancreatic cancer in Nord-Trondelag, Norway. Cancer Causes Control 11:645–652CrossRef Lund-Nilsen TI, Vateen LJ (2000) A prospective study of lifestyle factors and the risk of pancreatic cancer in Nord-Trondelag, Norway. Cancer Causes Control 11:645–652CrossRef
7.
Zurück zum Zitat Villeneuve PJ, Johnson KC, Hanley AJG, Mao Y (2000) Canadian cancer registries epidemiology research group. Alcohol, tobacco, and coffee consumption and the risk of pancreatic cancer: results from the Canadian Enhanced Surveillance System case-control project. Eur J Cancer Prev 9:49PubMedCrossRef Villeneuve PJ, Johnson KC, Hanley AJG, Mao Y (2000) Canadian cancer registries epidemiology research group. Alcohol, tobacco, and coffee consumption and the risk of pancreatic cancer: results from the Canadian Enhanced Surveillance System case-control project. Eur J Cancer Prev 9:49PubMedCrossRef
8.
Zurück zum Zitat 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 US cohort. Cancer Epidemiol Biomarkers Prev 14:459–466PubMedCrossRef 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 US cohort. Cancer Epidemiol Biomarkers Prev 14:459–466PubMedCrossRef
9.
Zurück zum Zitat Sasco AJ, Secretan MB, Straif K (2004) Tobacco smoking and cancer: a brief review of recent epidemiological evidence. Lung Cancer 45(Supp. 2):S3–S9PubMedCrossRef Sasco AJ, Secretan MB, Straif K (2004) Tobacco smoking and cancer: a brief review of recent epidemiological evidence. Lung Cancer 45(Supp. 2):S3–S9PubMedCrossRef
10.
Zurück zum Zitat Kaaks R, Lukanova A (2001) Energy balance and cancer: the role of insulin and insulin-like growth factor-I. Proc Nutr Soc 60:91–106PubMedCrossRef Kaaks R, Lukanova A (2001) Energy balance and cancer: the role of insulin and insulin-like growth factor-I. Proc Nutr Soc 60:91–106PubMedCrossRef
11.
Zurück zum Zitat Kazakoff K, Cardesa T, Liu J, et al. (1996) Effects of voluntary physical exercise on high-fat-diet-promoted pancreatic carcinogenesis in the hamster model. Nutr Cancer 26:265–279PubMedCrossRef Kazakoff K, Cardesa T, Liu J, et al. (1996) Effects of voluntary physical exercise on high-fat-diet-promoted pancreatic carcinogenesis in the hamster model. Nutr Cancer 26:265–279PubMedCrossRef
12.
Zurück zum Zitat 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 15:873–881PubMedCrossRef 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 15:873–881PubMedCrossRef
13.
Zurück zum Zitat Gapstur SM, Gann PH, Lowe W, Liu K, Colangelo L, Dyer A (2000) Abnormal glucose metabolism and pancreatic cancer mortality. JAMA 283:2552–2558PubMedCrossRef Gapstur SM, Gann PH, Lowe W, Liu K, Colangelo L, Dyer A (2000) Abnormal glucose metabolism and pancreatic cancer mortality. JAMA 283:2552–2558PubMedCrossRef
14.
Zurück zum Zitat 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 293:194–202PubMedCrossRef 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 293:194–202PubMedCrossRef
15.
Zurück zum Zitat Stolzenberg-Solomon RZ, Graubard BI, Chari S, et al. (2005) Insulin, glucose, insulin resistance, and pancreatic cancer in male smokers. JAMA 294:2872–2878PubMedCrossRef Stolzenberg-Solomon RZ, Graubard BI, Chari S, et al. (2005) Insulin, glucose, insulin resistance, and pancreatic cancer in male smokers. JAMA 294:2872–2878PubMedCrossRef
16.
Zurück zum Zitat Foster-Powell K, Holt SH, Brand-Miller JC (2002) International table of glycemic index and glycemic load values. Am J Clin Nutr 76:5–56PubMed Foster-Powell K, Holt SH, Brand-Miller JC (2002) International table of glycemic index and glycemic load values. Am J Clin Nutr 76:5–56PubMed
17.
Zurück zum Zitat Bjorck I, Elmstahl HL (2003) The glycaemic index: importance of dietary fibre and other food properties. Proc Nutr Soc 62:201–206PubMedCrossRef Bjorck I, Elmstahl HL (2003) The glycaemic index: importance of dietary fibre and other food properties. Proc Nutr Soc 62:201–206PubMedCrossRef
18.
Zurück zum Zitat Salmeron J, Ascherio A, Rimm EB, et al. (1997) Dietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care 20:545–550PubMed Salmeron J, Ascherio A, Rimm EB, et al. (1997) Dietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care 20:545–550PubMed
19.
Zurück zum Zitat Salmeron J, Manson JE, Stampfer MJ, Colditz GA, Wing AL, Willett WC (1997) Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. JAMA 277:472–477PubMedCrossRef Salmeron J, Manson JE, Stampfer MJ, Colditz GA, Wing AL, Willett WC (1997) Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. JAMA 277:472–477PubMedCrossRef
20.
Zurück zum Zitat Schulze MB, Liu S, Rimm EB, Manson JE, Willett WC, Hu FB (2004) Glycemic index, glycemic load, and dietary fiber intake and incidence of type 2 diabetes in younger and middle-aged women. Am J Clin Nutr 80:348–356PubMed Schulze MB, Liu S, Rimm EB, Manson JE, Willett WC, Hu FB (2004) Glycemic index, glycemic load, and dietary fiber intake and incidence of type 2 diabetes in younger and middle-aged women. Am J Clin Nutr 80:348–356PubMed
21.
Zurück zum Zitat Johnson KJ, Anderson KE, Harnack L, Hong C, Folsom AR (2005) No association between dietary glycemic index or load and pancreatic cancer incidence in postmenopausal women. Cancer Epidemiol Biomarkers Prev 14:1574–5PubMedCrossRef Johnson KJ, Anderson KE, Harnack L, Hong C, Folsom AR (2005) No association between dietary glycemic index or load and pancreatic cancer incidence in postmenopausal women. Cancer Epidemiol Biomarkers Prev 14:1574–5PubMedCrossRef
22.
Zurück zum Zitat Michaud DS, Liu S, Giovannucci E, Willett WC, Colditz GA, Fuchs CS (2002) Dietary sugar, glycemic load, and pancreatic cancer risk in a prospective study. J Nat Cancer Inst 4:1293–1300 Michaud DS, Liu S, Giovannucci E, Willett WC, Colditz GA, Fuchs CS (2002) Dietary sugar, glycemic load, and pancreatic cancer risk in a prospective study. J Nat Cancer Inst 4:1293–1300
23.
Zurück zum Zitat Silvera SAN, Rohan TE, Jain M, Terry PD, Howe GR, Miller AB (2005) Glycemic index, glycemic load, and pancreatic cancer risk (Canada). Cancer Causes Control 16:431–436PubMedCrossRef Silvera SAN, Rohan TE, Jain M, Terry PD, Howe GR, Miller AB (2005) Glycemic index, glycemic load, and pancreatic cancer risk (Canada). Cancer Causes Control 16:431–436PubMedCrossRef
24.
Zurück zum Zitat Howe GR, Jain M, Miller AB (1990) Dietary factors and risk of pancreatic cancer: results of a Canadian population-based case-control study. Int J Cancer 45:604–608PubMedCrossRef Howe GR, Jain M, Miller AB (1990) Dietary factors and risk of pancreatic cancer: results of a Canadian population-based case-control study. Int J Cancer 45:604–608PubMedCrossRef
25.
Zurück zum Zitat Lyon JL, Slattery ML, Mahoney AW, Robison LM (1993) Dietary intake as a risk factor for cancer of the exocrine pancreas. Cancer Epidemiol Biomarkers Prev 2:513–518PubMed Lyon JL, Slattery ML, Mahoney AW, Robison LM (1993) Dietary intake as a risk factor for cancer of the exocrine pancreas. Cancer Epidemiol Biomarkers Prev 2:513–518PubMed
26.
Zurück zum Zitat Kalapothaki V, Tzonou A, Hsieh C, et al. (1993) Nutrient intake and cancer of the pancreas: a case-control study in Athens, Greece. Cancer Causes Control 4:383–389PubMedCrossRef Kalapothaki V, Tzonou A, Hsieh C, et al. (1993) Nutrient intake and cancer of the pancreas: a case-control study in Athens, Greece. Cancer Causes Control 4:383–389PubMedCrossRef
27.
Zurück zum Zitat Olsen GW, Mandel JS, Gibson RW, Wattenberg LW, Schuman LM (1991) Nutrients and pancreatic cancer: a population-based case-control study. Cancer Causes Control 2:291–297PubMedCrossRef Olsen GW, Mandel JS, Gibson RW, Wattenberg LW, Schuman LM (1991) Nutrients and pancreatic cancer: a population-based case-control study. Cancer Causes Control 2:291–297PubMedCrossRef
28.
Zurück zum Zitat Silverman DT, Swanson CA, Gridley G, et al. (1998) Dietary and nutritional factors and pancreatic cancer: a case-control study based on direct interviews. J Nat Cancer Inst 90:1710–1719PubMedCrossRef Silverman DT, Swanson CA, Gridley G, et al. (1998) Dietary and nutritional factors and pancreatic cancer: a case-control study based on direct interviews. J Nat Cancer Inst 90:1710–1719PubMedCrossRef
29.
Zurück zum Zitat Polonsky KS, Sturis J, Bell GI (1996) Seminars in medicine of the beth Israel hospital, Boston. Non-insulin-dependent diabetes mellitus—a genetically programmed failure of the beta cell to compensate for insulin resistance. N Eng J Med 334:777–783CrossRef Polonsky KS, Sturis J, Bell GI (1996) Seminars in medicine of the beth Israel hospital, Boston. Non-insulin-dependent diabetes mellitus—a genetically programmed failure of the beta cell to compensate for insulin resistance. N Eng J Med 334:777–783CrossRef
30.
Zurück zum Zitat Wolever T, Bolognesi C (1992) Prediction of glucose and insulin responses of normal subjects after consuming mixed meals varying in energy, protein, fat, carbohydrate, and glycemic index. Nutrition 126:2807–2812 Wolever T, Bolognesi C (1992) Prediction of glucose and insulin responses of normal subjects after consuming mixed meals varying in energy, protein, fat, carbohydrate, and glycemic index. Nutrition 126:2807–2812
31.
Zurück zum Zitat Ludwig DS, Majzoub JA, Al-Zahrani A, Dallal GE, Blanco I, Roberts SB (1999) High glycemic index foods, overeating, and obesity. Pediatrics 103:E26PubMedCrossRef Ludwig DS, Majzoub JA, Al-Zahrani A, Dallal GE, Blanco I, Roberts SB (1999) High glycemic index foods, overeating, and obesity. Pediatrics 103:E26PubMedCrossRef
32.
Zurück zum Zitat Calle EE, Rodriguez C, Jacobs EJ, et al. (2002) The American Cancer Society Cancer Prevention Study II Nutrition Cohort-rational, study design, and baseline characteristics. Cancer 94:500–511PubMedCrossRef Calle EE, Rodriguez C, Jacobs EJ, et al. (2002) The American Cancer Society Cancer Prevention Study II Nutrition Cohort-rational, study design, and baseline characteristics. Cancer 94:500–511PubMedCrossRef
33.
Zurück zum Zitat Calle EE, Terrell DD (1993) Utility of the National Death Index for ascertainment of mortality among Cancer Prevention Study II participants. Am J Epidemiol 137:235–241PubMed Calle EE, Terrell DD (1993) Utility of the National Death Index for ascertainment of mortality among Cancer Prevention Study II participants. Am J Epidemiol 137:235–241PubMed
34.
Zurück zum Zitat World Health Organization (1977) International classification of diseases ninth revision. Manual of the international statistical classification of disease, injuries, and causes of death, 9th rev. ed., WHO, Geneva World Health Organization (1977) International classification of diseases ninth revision. Manual of the international statistical classification of disease, injuries, and causes of death, 9th rev. ed., WHO, Geneva
35.
Zurück zum Zitat World Health Organization (1992) International statistical classification of diseases and related health problems tenth revision, 10th ed., WHO, Geneva World Health Organization (1992) International statistical classification of diseases and related health problems tenth revision, 10th ed., WHO, Geneva
36.
Zurück zum Zitat Bergmann M, Calle E, Mervis C, Miracle-McMahill H, Thun M, Heath C (1998) Validity of self-reported cancers in a prospective cohort study in comparison to data from state cancer registries. Am J Epidemiol 147:556–562PubMed Bergmann M, Calle E, Mervis C, Miracle-McMahill H, Thun M, Heath C (1998) Validity of self-reported cancers in a prospective cohort study in comparison to data from state cancer registries. Am J Epidemiol 147:556–562PubMed
37.
Zurück zum Zitat Block G, Hartman AM, Naughton D (1990) A reduced dietary questionnaire: development and validation. Epidemiology 1:58–64PubMedCrossRef Block G, Hartman AM, Naughton D (1990) A reduced dietary questionnaire: development and validation. Epidemiology 1:58–64PubMedCrossRef
38.
Zurück zum Zitat Flagg EW, Coates RJ, Calle EE, Potischman N, Thun MJ (2000) Validation of the American Cancer Society Cancer Prevention Study II Nutrition Survey Cohort Food Frequency Questionnaire. Epidemiology 11:462–468PubMedCrossRef Flagg EW, Coates RJ, Calle EE, Potischman N, Thun MJ (2000) Validation of the American Cancer Society Cancer Prevention Study II Nutrition Survey Cohort Food Frequency Questionnaire. Epidemiology 11:462–468PubMedCrossRef
39.
Zurück zum Zitat Wolever TMS, Jenkins DJA (1986) The use of the glycemic index in predicting the blood glucose to mixed meals. Am J Clin Nutr 43:167–172PubMed Wolever TMS, Jenkins DJA (1986) The use of the glycemic index in predicting the blood glucose to mixed meals. Am J Clin Nutr 43:167–172PubMed
40.
Zurück zum Zitat Foster-Powell K, Brand Miller J (1995) International tables of glycemic index. Am J Clin Nutr 62:871S–893SPubMed Foster-Powell K, Brand Miller J (1995) International tables of glycemic index. Am J Clin Nutr 62:871S–893SPubMed
41.
Zurück zum Zitat Pennington JAT (1983) Revision of the total diet study food list and diets. J Am Diet Assoc 82:166–173PubMed Pennington JAT (1983) Revision of the total diet study food list and diets. J Am Diet Assoc 82:166–173PubMed
42.
Zurück zum Zitat Jonas CR, McCullough ML, Teras LR, Walker-Thurmond KA, Thun MJ, Calle EE (2003) Dietary glycemic index, glycemic load, and risk of incident breast cancer in postmenopausal women. Cancer Epidemiol Biomarkers Prev 12:573–577PubMed Jonas CR, McCullough ML, Teras LR, Walker-Thurmond KA, Thun MJ, Calle EE (2003) Dietary glycemic index, glycemic load, and risk of incident breast cancer in postmenopausal women. Cancer Epidemiol Biomarkers Prev 12:573–577PubMed
43.
Zurück zum Zitat Willett WC, Stampfer MJ (1986) Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 24:17–27 Willett WC, Stampfer MJ (1986) Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 24:17–27
44.
Zurück zum Zitat Cox D (1972) Regression models and life tables. J R Stat Soc 34:187–220 Cox D (1972) Regression models and life tables. J R Stat Soc 34:187–220
45.
Zurück zum Zitat Liu S (1998) Insulin resistance, hyperglycemia and risk of major chronic diseases-a dietary perspective. Proc Nutr Soc 22:140–150 Liu S (1998) Insulin resistance, hyperglycemia and risk of major chronic diseases-a dietary perspective. Proc Nutr Soc 22:140–150
46.
Zurück zum Zitat Kleinbaum G, Kupper L, Morgenstern H (1982) Epidemiologic research: principles and quantitative methods. New York: Van Nostrand Reinhold Co Kleinbaum G, Kupper L, Morgenstern H (1982) Epidemiologic research: principles and quantitative methods. New York: Van Nostrand Reinhold Co
Metadaten
Titel
Glycemic load, glycemic index, and carbohydrate intake in relation to pancreatic cancer risk in a large US cohort
verfasst von
Alpa V. Patel
Marjorie L. McCullough
Alexandre L. Pavluck
Eric J. Jacobs
Michael J. Thun
Eugenia E. Calle
Publikationsdatum
01.04.2007
Verlag
Kluwer Academic Publishers
Erschienen in
Cancer Causes & Control / Ausgabe 3/2007
Print ISSN: 0957-5243
Elektronische ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-006-0081-z

Weitere Artikel der Ausgabe 3/2007

Cancer Causes & Control 3/2007 Zur Ausgabe

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

CUP-Syndrom: Künstliche Intelligenz kann Primärtumor finden

30.04.2024 Künstliche Intelligenz Nachrichten

Krebserkrankungen unbekannten Ursprungs (CUP) sind eine diagnostische Herausforderung. KI-Systeme können Pathologen dabei unterstützen, zytologische Bilder zu interpretieren, um den Primärtumor zu lokalisieren.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.