Journal Article

DKFZ-2026-01559

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Adherence to the Mediterranean diet and risk of pancreatic cancer: an analysis of 2.3 million participants in the Pooling Project of Prospective Studies of Diet and Cancer (DCPP).

Shen, Q. ; Mobley, C. ; Wang, M. ; Ferrari, P. ; Adami, H.-O. ; Afshar, N. ; Babic, A. ; van den Brandt, P. A. ; Cheng, E. ; Eliassen, A. H. ; Fung, T. T. ; Giovannucci, E. L. ; Hirabayashi, M. ; Hou, T. ; Huang, B. Z. ; Huang, W.-Y. ; Joshu, C. E. ; Kanehara, R. ; Katzke, V.DKFZ* ; Lacey, J. V. ; Landry, M. J. ; Larsson, S. C. ; Liao, L. M. ; Martinez, M. E. ; McCullough, M. L. ; Miller, A. B. ; Milne, R. L. ; Moore, S. C. ; Mucci, L. A. ; Naudin, S. ; Prizment, A. ; Park, S.-Y. ; Rohan, T. E. ; Riboli, E. ; Robien, K. ; Sandin, S. ; Sawada, N. ; Shams-White, M. M. ; Sinha, R. ; Smith-Byrne, K. ; Stampfer, M. J. ; Stolzenberg-Solomon, R. Z. ; Um, C. Y. ; Visvanathan, K. ; Wang, S. S. ; Weiderpass, E. ; White, E. ; Willett, W. C. ; Wolk, A. ; Wolpin, B. M. ; Yuan, C. ; Smith-Warner, S. A. ; Genkinger, J. M.

2026
Springer Nature Switzerland AG [Cham]

Abstract: Pancreatic cancer incidence is rising, yet few modifiable risk factors have been identified. The Mediterranean diet, which lowers inflammation and improves healthy weight maintenance and insulin control, may lower pancreatic cancer risk, yet the evidence for this association is inconsistent. To investigate the association, we conducted a pooled analysis of 2,315,406 individuals from 23 prospective cohorts in the Pooling Project of Prospective Studies of Diet and Cancer (DCPP), of whom 10,748 developed incident pancreatic cancer over a mean follow-up duration ranging from 8.1 to 23.3 years across studies. Adherence to the Mediterranean diet was assessed using the alternative Mediterranean diet score (aMED) and a modified score excluding alcohol (maMED). Study- and sex-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models and then pooled using random effect models. No statistically significant association was found between aMED or maMED and pancreatic cancer or pancreatic ductal adenocarcinoma (PDAC) risk. For aMED, the pooled pancreatic cancer HR was 0.96 (95% CI: 0.90-1.02) comparing the fourth to the first quartile, 0.94 (0.88-1.00) comparing high (6-9) versus low (0-3) scores, and 0.98 (0.96-1.00) per 2-unit increment in the score. Overall, there was no evidence of heterogeneity in these associations by sex, attained age, race, BMI, physical activity, or follow-up time; a positive association between maMED and pancreatic cancer risk was observed in past smokers (HR = 1.04, 95% CI 1.00-1.09) but not in never or current smokers (Pinteraction=0.04). In conclusion, there was little evidence of an association between a Mediterranean diet score and pancreatic cancer risk in this large international pooled analysis.

Keyword(s): Dietary patterns ; Mediterranean diet ; Pancreas ; Pancreatic cancer ; Pooled analysis ; Pooling project

Note: epub

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Contributing Institute(s):

1. Epidemiologie von Krebs (C020)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2026

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; DEAL Springer ; DEAL Springer ; Essential Science Indicators ; IF >= 10 ; JCR ; National-Konsortium ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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