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22.06.2019 | Original Paper | Ausgabe 9/2019 Open Access

Cancer Causes & Control 9/2019

Trajectories of body mass index, from adolescence to older adulthood, and pancreatic cancer risk; a population-based case–control study in Ontario, Canada

Cancer Causes & Control > Ausgabe 9/2019
Vanessa De Rubeis, Michelle Cotterchio, Brendan T. Smith, Lauren E. Griffith, Ayelet Borgida, Steven Gallinger, Sean Cleary, Laura N. Anderson
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The online version of this article (https://​doi.​org/​10.​1007/​s10552-019-01197-9) contains supplementary material, which is available to authorized users.

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Pancreatic cancer has the highest fatality rate of all cancers. Adulthood obesity is an established risk factor for pancreatic cancer; however, life-course obesity is not well understood. The aim of this study was to evaluate the association between body mass index (BMI) trajectories throughout the life-course and pancreatic cancer risk.


A population-based case–control study was conducted (2011–2013) in Ontario, Canada. Cases were recruited from the Ontario pancreas cancer study (n = 310) and controls from the Ontario cancer risk factor study (n = 1258). Questionnaires captured self-reported height and weight at four timepoints (adolescence, 20 s, 30–40 s, 50–60 s). BMI trajectories were identified using latent class growth mixture modeling. Odds ratios (OR) and 95% confidence intervals (CI) were estimated from multivariable logistic regression.


Five BMI trajectories were identified: stable-normal weight (38.9%), progressively overweight (42.2%), persistent overweight (12.6%), progressive obesity (4.2%), and persistent obesity (2.1%). The persistent overweight (OR = 1.55; 95% CI 1.02, 2.39) and progressive obesity trajectories (OR = 1.49; 95% CI 0.77, 2.87) compared to stable-normal weight were associated with increased odds of pancreatic cancer. When BMI was evaluated separately the strongest associations with pancreatic cancer emerged in young and mid-adulthood.


BMI trajectories characterized by overweight in early adulthood were associated with increased pancreatic cancer risk suggesting a life-course approach to disease risk.

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