Table 2. Hazard ratios (95% confidence intervals) of pancreatic cancer by country-specific levels of adherence to the arMED score in the EPIC cohort (n=477 309).
|
arMED score |
Per two unit increment in arMED score |
||||
|---|---|---|---|---|---|
| Low (0–5) HR (95% CI) | Medium (6–9) HR (95% CI) | High (10–16) HR (95% CI) | P-value for trend | HR (95% CI) | |
|
All (n=865 cases) | |||||
| Cases/person-years | 277/1 245 196 | 402/2 483 735 | 186/1 534 067 | ||
| Crude HR (95% CI) | 1.00 | 0.94 (0.80–1.11) | 0.88 (0.69–1.12) | 0.24 | 0.98 (0.95–1.01) |
| Multivariate HR (95% CI) | 1.00 | 1.01 (0.85–1.19) | 0.99 (0.77–1.26) | 0.95 | 1.00 (0.94–1.06) |
| Men (n=396 cases) |
P-value for interaction: 0.90 |
||||
| Cases/person-years | 165/565 143 | 160/649 987 | 71/376 379 | ||
| Crude HR (95% CI) | 1.00 | 0.92 (0.73–1.16) | 0.88 (0.59–1.30) | 0.45 | 0.97 (0.88–1.06) |
| Multivariate HR (95% CI) | 1.00 | 0.99 (0.78–1.25) | 1.00 (0.68–1.49) | 0.99 | 1.01 (0.92–1.11) |
|
Women (n=469 cases) | |||||
| Cases/person-years | 112/680 053 | 242/1 833 748 | 115/1 157 688 | ||
| Crude HR (95% CI) | 1.00 | 0.96 (0.76–1.21) | 0.89 (0.65–1.22) | 0.46 | 0.96 (0.88–1.04) |
| Multivariate HR (95% CI) | 1.00 | 1.03 (0.82–1.31) | 0.99 (0.72–1.37) | 0.98 | 0.99 (0.91–1.08) |
| Age <60 years (n=486 cases) |
P-value for interaction: 0.59 |
||||
| Cases/person-years | 168/965 742 | 225/1 970 708 | 93/1 249 488 | ||
| Crude HR (95% CI) | 1.00 | 0.88 (0.71–1.09) | 0.71 (0.51–0.98) | 0.04 | 0.94 (0.87–1.03) |
| Multivariate HR (95% CI) | 1.00 | 0.95 (0.76–1.18) | 0.80 (0.58–1.12) | 0.23 | 0.98 (0.90–1.07) |
|
Age ⩾60 years (n=379 cases) | |||||
| Cases/person-years | 109/279 454 | 177/513 027 | 93/284 579 | ||
| Crude HR (95% CI) | 1.00 | 1.03 (0.80–1.33) | 1.16 (0.80–1.67) | 0.46 | 0.99 (0.89–1.08) |
| Multivariate HR (95% CI) | 1.00 | 1.10 (0.85–1.41) | 1.30 (0.89–1.87) | 0.18 | 1.02 (0.92–1.12) |
|
Never smoker (n=336 cases) |
P-value for interaction: 0.56 |
||||
| Cases/person-years | 81/518 518 | 169/1 229 294 | 86/847 954 | ||
| Crude HR (95% CI) | 1.00 | 1.02 (0.77–1.36) | 0.91 (0.62–1.34) | 0.65 | 0.98 (0.88–1.08) |
| Multivariate HR (95% CI) | 1.00 | 1.03 (0.77–1.37) | 0.92 (0.63–1.37) | 0.71 | 0.98 (0.89–1.09) |
|
Former smoker (n=239 cases) | |||||
| Cases/person-years | 68/340 265 | 115/681 518 | 56/376 769 | ||
| Crude HR (95% CI) | 1.00 | 1.13 (0.83–1.55) | 1.35 (0.87–2.12) | 0.19 | 1.03 (0.92–1.16) |
| Multivariate HR (95% CI) | 1.00 | 1.15 (0.83–1.57) | 1.42 (0.91–2.22) | 0.13 | 1.05 (0.93–1.18) |
|
Smoker (n=247 cases) | |||||
| Cases/person-years | 126/371 157 | 109/519 272 | 40/278 996 | ||
| Crude HR (95% CI) | 1.00 | 0.84 (0.64–1.12) | 0.66 (0.40–1.08) | 0.09 | 0.94 (0.84–1.05) |
| Multivariate HR (95% CI) | 1.00 | 0.86 (0.65–1.14) | 0.67 (0.41–1.11) | 0.11 | 0.95 (0.85–1.06) |
|
Non-diabetics (n=776 cases) |
P-value for interaction: 0.11 |
||||
| Cases/person-years | 259/1 174 297 | 355/2 321 163 | 162/1 448 174 | ||
| Crude HR (95% CI) | 1.00 | 0.89 (0.75–1.05) | 0.81 (0.63–1.05) | 0.09 | 0.97 (0.94–1.00) |
| Multivariate HR (95% CI) | 1.00 | 0.95 (0.80–1.13) | 0.91 (0.70–1.19) | 0.48 | 0.98 (0.91–1.04) |
|
Obese (n=144 cases)a |
P-value for interaction: 0.43 |
||||
| Cases/person-years | 45/161 481 | 65/290 699 | 34/245 613 | ||
| Crude HR (95% CI) | 1.00 | 1.03 (0.67–1.57) | 0.53 (0.28–1.03) | 0.11 | 0.90 (0.77–1.05) |
| Multivariate HR (95% CI) | 1.00 | 1.06 (0.69–1.64) | 0.56 (0.29–1.08) | 0.14 | 0.91 (0.78–1.08) |
|
Overweight (n=363 cases)b | |||||
| Cases/person-years | 115/478 180 | 164/ 837 232 | 84/527 638 | ||
| Crude HR (95% CI) | 1.00 | 0.99 (0.77–1.28) | 1.05 (0.72–1.53) | 0.83 | 0.99 (0.90–1.09) |
| Multivariate HR (95% CI) | 1.00 | 1.08 (0.83–1.40) | 1.19 (0.81–1.73) | 0.38 | 1.03 (0.94–1.14) |
|
Normal weight (n=358 cases)b | |||||
| Cases/person-years | 117/605 535 | 173/1 355 804 | 68/760 817 | ||
| Crude HR (95% CI) | 1.00 | 0.90 (0.70–1.16) | 0.92 (0.64–1.32) | 0.56 | 0.98 (0.94–1.03) |
| Multivariate HR (95% CI) | 1.00 | 0.97 (0.75–1.25) | 1.02 (0.70–1.47) | 0.97 | 1.00 (0.90–1.10) |
|
Physically active (n=173 cases) |
P-value for interaction: 0.46 |
||||
| Cases/person-years | 117/555 538 | 157/980 914 | 49/560 756 | ||
| Crude HR (95% CI) | 1.00 | 1.04 (0.80–1.34) | 0.81 (0.53–1.24) | 0.53 | 0.98 (0.89–1.09) |
| Multivariate HR (95% CI) | 1.00 | 1.09 (0.84–1.41) | 0.89 (0.58–1.36) | 0.86 | 1.01 (0.91–1.12) |
|
Non-physically active (n=505 cases) | |||||
| Cases/person-years | 151/596 061 | 220/1 231 169 | 134/908 833 | ||
| Crude HR (95% CI) | 1.00 | 0.88 (0.70–1.10) | 0.92 (0.67–1.26) | 0.58 | 0.97 (0.89–1.05) |
| Multivariate HR (95% CI) | 1.00 | 0.94 (0.75–1.18) | 1.04 (0.75–1.43) | 0.89 | 1.00 (0.92–1.09) |
|
Non-drinkers (n=109 cases)a |
P-value for interaction: 0.20 |
||||
| Cases/person-years | 34/127 697 | 45/300 841 | 30/277 857 | ||
| Crude HR (95% CI) | 1.00 | 0.78 (0.48–1.27) | 0.68 (0.33–1.39) | 0.26 | 0.92 (0.77–1.11) |
| Multivariate HR (95% CI) | 1.00 | 0.84 (0.51–1.39) | 0.78 (0.38–1.63) | 0.49 | 0.97 (0.80–1.16) |
|
Moderate drinkers (n=437 cases)a | |||||
| Cases/person-years | 120/697 692 | 123/1 422 417 | 104/836 632 | ||
| Crude HR (95% CI) | 1.00 | 1.08 (0.85–1.37) | 1.13 (0.81–1.58) | 0.46 | 1.03 (0.94–1.12) |
| Multivariate HR (95% CI) | 1.00 | 1.12 (0.88–1.43) | 1.20 (0.86–1.69) | 0.27 | 1.05 (0.96–1.15) |
|
Drinkers (n=319 cases)a | |||||
| Cases/person-years | 123/419 807 | 144/760 477 | 52/419 578 | ||
| Crude HR (95% CI) | 1.00 | 0.85 (0.66–1.11) | 0.73 (0.48–1.11) | 0.12 | 0.90 (0.81–1.00) |
| Multivariate HR (95% CI) | 1.00 | 0.95 (0.73–1.24) | 0.84 (0.55–1.29) | 0.45 | 0.95 (0.85–1.05) |
|
Abdominal obese (n=237 cases)b |
P-value for interaction: 0.76 |
||||
| Cases/person-years | 69/226 129 | 106/373 247 | 62/328 889 | ||
| Crude HR (95% CI) | 1.00 | 1.20 (0.87–1.67) | 0.87 (0.53–1.44) | 0.84 | 0.96 (0.85–1.09) |
| Multivariate HR (95% CI) | 1.00 | 1.29 (0.92–1.80) | 0.98 (0.59–1.62) | 0.80 | 0.99 (0.87–1.12) |
|
Normal/moderate WC (n=522 cases)b | |||||
| Cases/person-years | 172/727 819 | 247/1 465 094 | 103/990 891 | ||
| Crude HR (95% CI) | 1.00 | 0.90 (0.74–1.11) | 0.82 (0.60–1.12) | 0.20 | 0.97 (0.89–1.05) |
| Multivariate HR (95% CI) | 1.00 | 0.97 (0.79–1.20) | 0.94 (0.68–1.28) | 0.68 | 1.01 (0.93–1.09) |
|
Southern Europe (n=163 cases)c |
P-value for interaction: 0.11 |
||||
| Cases/person-years | 2/22 293 | 67/434 389 | 94/774 018 | ||
| Crude HR (95% CI) | 1.00 | 1.57 (0.38–6.48) | 1.07 (0.26–4.45) | 0.06 | 0.86 (0.74–1.00) |
| Multivariate HR (95% CI) | 1.00 | 1.60 (0.39–6.61) | 1.16 (0.28–4.81) | 0.12 | 0.88 (0.76–1.03) |
|
Central Europe (n=341 cases)c | |||||
| Cases/person-years | 93/577 960 | 179/1 255 044 | 69/616 619 | ||
| Crude HR (95% CI) | 1.00 | 1.06 (0.82–1.38) | 1.25 (0.87–1.80) | 0.25 | 1.04 (0.94–1.15) |
| Multivariate HR (95% CI) | 1.00 | 1.10 (0.85–1.44) | 1.33 (0.92–1.93) | 0.14 | 1.06 (0.96–1.17) |
|
Northern Europe (n=361 cases)c | |||||
| Cases/person-years | 182/644 942 | 156/794 302 | 23/143 430 | ||
| Crude HR (95% CI) | 1.00 | 0.83 (0.67–1.04) | 0.79 (0.50–1.23) | 0.10 | 0.94 (0.85–1.03) |
| Multivariate HR (95% CI) | 1.00 | 0.92 (0.73–1.15) | 0.93 (0.59–1.47) | 0.52 | 0.99 (0.90–1.09) |
Crude HRs—stratified by age (1-year categories), sex and centre.
Multivariate HRs—adjusted for total energy intake (continuous), body mass index (continuous), smoking status and intensity (never; current, 1–15 cigarettes per day; current, 16–25 cigarettes per day; current, 26+ cigarettes per day; former, quit ⩽10 years; former, quit 11–20 years; former, quit 20+ years; current, pipe/cigar/occasional; current/former, missing; unknown), alcohol intake (non-drinkers, drinkers of 0–6 g per day, >6–12 g per day, >12–24 g per day, >24–60 g per day, women drinkers of: >60 g per day, men drinkers of: >60–96 g per day, >96 g per day), diabetes (verified, not verified but self-reported, not diabetes, missing), and stratified by age (1-year categories), sex and centre. Abdominal obesity, according to NCEP/ATPIII criteria, was defined as waist circumference ⩾102 cm in men or ⩾88 cm in women, and normal and moderate waist circumference as <120 cm or <88 cm in men and women, respectively. Multivariate HRs additionally controlling for BMI retrieved similar estimates.
Non-drinkers: 0 drinks per day (0 g per day alcohol); moderate drinkers: no more than 1 drink/d (>=12 g per day alcohol); drinkers: more than 1 drink per day (>12 g per day alcohol).
Obese, overweight and normal weight was defined according to WHO criteria, as ⩾30 kg m2, 25–30 kg m2 and ⩽25 kg m2, respectively.
Southern Europe: Spain, Italy and Greece; Central Europe: France, Germany, UK and The Netherlands; Northern Europe: Sweden, Denmark and Norway.