Cancer Epidemiol Biomarkers Prev. 2022 Oct 28. pii: EPI-22-0564. [Epub ahead of print]
BACKGROUND: Data on diet quality and pancreatic cancer are limited. We examined the relationship between diet quality, assessed by the Healthy Eating Index-2015 (HEI-2015), the Alternative Healthy Eating Index-2010 (AHEI-2010), the alternate Mediterranean Diet (aMED) score, the Dietary Approaches to Stop Hypertension (DASH) score and the energy-adjusted Dietary Inflammatory Index (E-DII®), and pancreatic cancer incidence in the Multiethnic Cohort Study.METHODS: Diet quality scores were calculated from a validated food frequency questionnaire administered at baseline. Cox models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for age, sex, race/ethnicity, education, diabetes, family history of pancreatic cancer, physical activity, smoking variables, total energy intake, body mass index (BMI) and alcohol consumption. Stratified analyses by sex, race/ethnicity, smoking status and BMI were conducted.
RESULTS: Over an average follow-up of 19.3 years, 1,779 incident pancreatic cancer cases were identified among 177,313 participants (average age of 60.2 years at baseline, 1993-1996). Overall, we did not observe associations between the dietary pattern scores and pancreatic cancer (aMED: 0.98, 0.83-1.16; HEI-2015: 1.03, 0.88-1.21; AHEI-2010: 1.03, 0.88-1.20; DASH: 0.92, 0.79-1.08; E-DII: 1.05, 0.89-1.23). An inverse association was observed with DASH for ever smokers (HR: 0.75, 0.61-0.93), but not for non-smokers (HR: 1.05, 0.83-1.32).
CONCLUSION: The DASH diet showed an inverse association with pancreatic cancer among ever smokers, but does not show a protective association overall.
IMPACT: Modifiable measures are needed to reduce pancreatic cancer burden in these high-risk populations; our study adds to the discussion of the benefit of dietary changes.