Alcohol and Pancreatic Cancer

Research findings are inconsistent on the association between alcohol intake and pancreatic cancer. The authors of this study prospectively examined data from 470,681 participants in the National Institutes of Health (NIH)-AARP Diet and Health Study who were aged 50–71 years between 1995–1996. They identified 1149 cases of pancreatic cancer through December 2003. Multivariable Cox proportional hazards regression models were used to calculate relative risks (RRs) for pancreatic cancer in relation to alcohol use or cigarette smoking, with the referent group being light drinkers (<1 drink* per day).

• Compared with light drinkers, subjects reporting consumption of ≥3 drinks per day had a fully adjusted RR of developing pancreatic cancer of 1.45 (1.62 for those consuming ≥3 drinks per day of liquor). The increased risk was seen especially in never smokers (RR, 1.35) and participants who quit smoking 10 or more years earlier (RR, 1.41).

• The adjusted RR was 1.14 for those who reported no alcohol consumption (95% CI: 0.99, 1.32), 0.92 for those consuming 1–2 drinks per day,** and 1.03 for those consuming 2–3 drinks per day.** (Current nondrinkers who were former drinkers could not be identified.)

• Beverage-specific effects revealed no increase in risk for consumers of any amounts of beer or wine or for consumers of liquor up to 3 drinks per day.

Comments:

Heavy alcohol use is associated with an increased risk of chronic pancreatitis, which may put patients at risk for pancreatic cancer. In this study, an increased risk was seen among subjects who reported either no alcohol consumption (a group that probably contained former drinkers) or consuming 3 or more drinks per day of liquor. I agree with the conclusions of the authors that, although moderate alcohol use was not a risk factor for pancreatic cancer in this study, heavy alcohol use, particularly of liquor, may play a role in its etiology.

R. Curtis Ellison, MD

Reference:

Jiao L, Silverman DT, Schairer C, et al. Alcohol use and risk of pancreatic cancer: the NIH-AARP Diet and Health Study. Am J Epidemiol. 2009;169(9):1043–1051.