The authors state that to examine prospectively the relation between alcohol consumption and pancreatic cancer risk, they analysed data from the Netherlands Cohort Study. Participants were 120,852 persons who completed a baseline questionnaire in 1986. After 13.3 years of follow up, 350 cases of pancreatic cancer (67% microscopically confirmed) were available for analysis.
Compared with abstention, the highest category of alcohol consumption (≥30 g/day of ethanol) was positively associated with pancreatic cancer risk (for all cases, rate ratio =1.57, 95% confidence interval: 1.03, 2.39; Ptrend = 0.12; for microscopically confirmed cases, rate ratio = 1.54, 95% confidence interval: 0.94, 2.54; Ptrend = 0.22). In a subgroup of stable alcohol users (no change during the 5 years before baseline), a similarly increased risk of pancreatic cancer was found. This increased risk was limited to the first 7 years of follow up. No associations were observed between consumption of specific alcoholic beverages and risk of pancreatic cancer. The associations were not modified by folate intake or smoking. Overall, these findings suggest an increased pancreatic cancer risk for persons with a high ethanol intake (≥30 g/day). However, this increased risk was observed only during the first 7 years of follow up.
Professor R Curtis Ellison comments: This study is from a large prospective cohort of more than 100,000 subjects, yet the total number of cases of pancreatic cancer were not large enough for many sub-group analyses (such as beverage-specific effects). For microscopically verified cancer cases, there were only 48 abstainers and 36 heavy users, almost all of whom were men. Overall, the study shows an increase in the risk of pancreatic cancer for people reporting heavy alcohol intake.
The results are similar to those of the paper by Jiao that we reviewed in May: in that study of more than 1,000 subjects with pancreatic cancer, there was some increase in risk for heavy drinkers. The present results are also similar to the current report from Yadov for pancreatitis which found that heavy drinkers were at increased risk of acute and chronic pancreatitis. In the present study, there was no evidence of an increase in risk for subjects consuming up to 30 grams of alcohol/day (about 2 1/2 typical US drinks).
Source: Alcohol consumption and risk of pancreatic cancer in the Netherlands Cohort Study. Heinen MM, Verhage BAJ, Ambergen TAW, Goldbohm RA, van den Brandt PA. Am J Epidemiol 2009;169:12331242.