Mediterranean diet and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition cohort

Esther Molina-Montes, María José Sánchez, Genevieve Buckland, H. B. Bueno-De-Mesquita, Elisabete Weiderpass, Pilar Amiano, Petra A. Wark, Tilman Kühn, Verena Katzke, José María Huerta, Eva Ardanaz, José Ramón Quirós, Aurélie Affret, Mathilde His, Marie Christine Boutron-Ruault, Petra H. Peeters, Weimin Ye, Malin Sund, Heiner Boeing, Khalid IqbalBodil Ohlsson, Emily Sonestedt, Anne Tjønneland, Kristina E N Petersen, Ruth C. Travis, Guri Skeie, Claudia Agnoli, Salvatore Panico, Domenico Palli, Rosario Tumino, Carlotta Sacerdote, Heinz Freisling, Inge Huybrechts, Kim Overvad, Antonia Trichopoulou, Christina Bamia, Effie Vasilopoulou, Nick Wareham, Kay Tee Khaw, Amanda J. Cross, Heather A. Ward, Elio Riboli, Eric J. Duell

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    Background:The Mediterranean diet (MD) has been proposed as a means for cancer prevention, but little evidence has been accrued regarding its potential to prevent pancreatic cancer. We investigated the association between the adherence to the MD and pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.Methods:Over half a million participants from 10 European countries were followed up for over 11 years, after which 865 newly diagnosed exocrine pancreatic cancer cases were identified. Adherence to the MD was estimated through an adapted score without the alcohol component (arMED) to discount alcohol-related harmful effects. Cox proportional hazards regression models, stratified by age, sex and centre, and adjusted for energy intake, body mass index, smoking status, alcohol intake and diabetes status at recruitment, were used to estimate hazard ratios (HRs) associated with pancreatic cancer and their corresponding 95% confidence intervals (CIs).Results:Adherence to the arMED score was not associated with risk of pancreatic cancer (HR high vs low adherence=0.99; 95% CI: 0.77-1.26, and HR per increments of two units in adherence to arMED=1.00; 95% CI: 0.94-1.06). There was no convincing evidence for heterogeneity by smoking status, body mass index, diabetes or European region. There was also no evidence of significant associations in analyses involving microscopically confirmed cases, plausible reporters of energy intake or other definitions of the MD pattern.Conclusions:A high adherence to the MD is not associated with pancreatic cancer risk in the EPIC study.

    Original languageEnglish
    Pages (from-to)811-820
    Number of pages10
    JournalBritish Journal of Cancer
    Issue number6
    Early online date7 Feb 2017
    Publication statusPublished - 14 Mar 2017


    • cohort study
    • Mediterranean diet
    • pancreatic cancer

    ASJC Scopus subject areas

    • Oncology
    • Cancer Research


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