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Obesity and survival in population-based patients with pancreatic cancer in the San Francisco Bay Area

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Abstract

Background

Obesity has been consistently associated with increased risk of pancreatic cancer incidence and mortality. However, studies of obesity and overall survival in patients with pancreatic cancer are notably lacking, especially in population-based studies.

Methods

Active and passive follow-up were used to determine vital status and survival for 510 pancreatic cancer patients diagnosed from 1995 to 1999 in a large population-based case–control study in the San Francisco Bay Area. Survival rates were computed using Kaplan–Meier methods. Hazard ratios (HR) and 95 % confidence intervals (CI) were estimated in multivariable Cox proportional hazards models as measures of the association between pre-diagnostic obesity and pancreatic cancer survival.

Results

An elevated hazard ratio of 1.3 (95 % CI, 0.91–1.81) was observed for obese [body mass index (BMI) ≥ 30] compared with normal range BMI (<25) patients. Associations between BMI and overall survival did not statistically significantly vary by known prognostic and risk factors (all p-interaction ≥0.18), yet elevated HRs consistently were observed for obese compared with normal BMI patients [localized disease at diagnosis (HR, 3.1), surgical resection (HR, 1.6), ever smokers (HR, 1.6), diabetics (HR, 3.3)]. Poor survival was observed among men, older patients, more recent and current smokers, whereas improved survival was observed for Asian/Pacific Islanders.

Conclusions

Our results in general provide limited support for an association between pre-diagnostic obesity and decreased survival in patients with pancreatic cancer. Patterns of reduced survival associated with obesity in some patient subgroups could be due to chance and require assessment in larger pooled studies.

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Acknowledgments

This work was supported in part by National Cancer Institute grants (CA59706, CA108370, CA109767, CA89726, and CA121846 to E.A. Holly) and by the Rombauer Pancreatic Cancer Research Fund. The collection of cancer incidence data for the UCSF study was supported by the California Department of Public Health as part of the statewide cancer reporting program; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract N01-PC-35136 awarded to the Northern California Cancer Center; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries under agreement #U55/CCR921930-02 awarded to the Public Health Institute.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, University of California San Francisco, 3333 California Street, Suite 280, San Francisco, CA, 94118-1944, USA

    Zhihong Gong, Elizabeth A. Holly & Paige M. Bracci

  2. Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA

    Zhihong Gong

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  1. Zhihong Gong
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  2. Elizabeth A. Holly
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  3. Paige M. Bracci
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Correspondence to Paige M. Bracci.

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Gong, Z., Holly, E.A. & Bracci, P.M. Obesity and survival in population-based patients with pancreatic cancer in the San Francisco Bay Area. Cancer Causes Control 23, 1929–1937 (2012). https://doi.org/10.1007/s10552-012-0070-3

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  • DOI: https://doi.org/10.1007/s10552-012-0070-3

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