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).

Authors

Qinting Shen, Claire Mobley, Molin Wang, Pietro Ferrari, Hans-Olov Adami, Nina Afshar, Ana Babic, Piet A van den Brandt, En Cheng, A Heather Eliassen, Teresa T Fung, Edward L Giovannucci, Mayo Hirabayashi, Tao Hou, Brian Z Huang, Wen-Yi Huang, Corinne E Joshu, Rieko Kanehara, Verena Katzke, James V Lacey, Matthew J Landry, Susanna C Larsson, Linda M Liao, Maria Elena Martinez, Marjorie L McCullough, Anthony B Miller, Roger L Milne, Steven C Moore, Lorelei A Mucci, Sabine Naudin, Anna Prizment, Song-Yi Park, Thomas E Rohan, Elio Riboli, Kim Robien, Sven Sandin, Norie Sawada, Marissa M Shams-White, Rashmi Sinha, Karl Smith-Byrne, Meir J Stampfer, Rachael Z Stolzenberg-Solomon, Caroline Y Um, Kala Visvanathan, Sophia S Wang, Elisabete Weiderpass, Emily White, Walter C Willett, Alicja Wolk, Brian M Wolpin, Chen Yuan, Stephanie A Smith-Warner, Jeanine M Genkinger

Published in

European journal of epidemiology. Jun 25, 2026. Epub Jun 25, 2026.

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 (P_interaction=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.

PMID:
42348090
Bibliographic data and abstract were imported from PubMed on 25 Jun 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.