Table 3.
Associations of aMED and mMED (in‐ and excluding alcohol) with microscopically confirmed pancreatic cancer risk in men
| aMED | mMED | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 0–3 | 4–5 | 6–81 | p trend | Continuous2 | 0‐3 | 4‐5 | 6‐81 | p trend | Continuous2 | |||
| NLCS | Excluding alcohol | N cases/PYsubcohort | 83/11,934 | 80/12,620 | 24/4,809 | 187/29,363 | 65/10,970 | 102/13,580 | 20/4,814 | 187/29,363 | ||
| HRage (95% CI)3 | 1.00 | 0.91 (0.66–1.26) | 0.70 (0.44–1.13) | 0.144 | 0.95 (0.79–1.15) | 1.00 | 1.25 (0.90–1.73) | 0.69 (0.41–1.16) | 0.188 | 0.96 (0.80–1.15) | ||
| HRfully adjusted (95% CI)4 | 1.00 | 0.93 (0.66–1.30) | 0.73 (0.44–1.21) | 0.225 | 0.98 (0.80–1.20) | 1.00 | 1.31 (0.93–1.84) | 0.69 (0.41–1.18) | 0.210 | 0.97 (0.80–1.17) | ||
| Including alcohol | N cases/PYsubcohort | 65/9,277 | 84/13,072 | 38/7,014 | 187/29,363 | 40/7,821 | 111/14,133 | 36/7,409 | 187/29,363 | |||
| HRfully adjusted (95% CI)5 | 1.00 | 0.95 (0.67–1.34) | 0.80 (0.51–1.26) | 0.392 | 0.92 (0.76–1.10) | 1.00 | 1.50 (1.01–2.24) | 0.91 (0.56–1.48) | 0.301 | 0.95 (0.80–1.13) | ||
| EPIC‐NL | Excluding alcohol | N cases/PYcohort | 14/64,824 | 13/70,567 | 3/31,053 | 30/166,444 | 11/64,065 | 17/73,238 | 2/29,141 | 30/166,444 | ||
| HRage (95% CI)6 | 1.00 | 0.84 (0.39–1.79) | 0.42 (0.12–1.45) | 0.164 | 0.78 (0.50–1.21) | 1.00 | 1.22 (0.57–2.60) | 0.34 (0.08–1.55) | 0.189 | 0.97 (0.61–1.53) | ||
| HRfully adjusted (95% CI)7 | 1.00 | 0.94 (0.44–2.02) | 0.52 (0.14–1.86) | 0.323 | 0.87 (0.55–1.38) | 1.00 | 1.39 (0.64–3.01) | 0.46 (0.10–2.12) | 0.412 | 1.15 (0.71–1.87) | ||
| Including alcohol | N cases/PYcohort | 12/50,128 | 14/70,079 | 4/46,237 | 30/166,444 | 8/47,054 | 16/74,225 | 6/45,166 | 30/166,444 | |||
| HRfully adjusted (95% CI)8 | 1.00 | 0.92 (0.42–2.02) | 0.44 (0.14–1.42) | 0.165 | 0.92 (0.60–1.42) | 1.00 | 1.32 (0.56–3.13) | 0.86 (0.29–2.56) | 0.993 | 1.07 (0.68–1.69) | ||
| Pooled9 | Excluding alcohol | N cases | 97 | 93 | 27 | 217 | 76 | 119 | 22 | 217 | ||
| HRfully adjusted (95% CI) | 1.00 | 0.93 (0.68–1.26) | 0.70 (0.44–1.12) | 0.135 | 0.96 (0.80–1.16) | 1.00 | 1.32 (0.97–1.81) | 0.66 (0.40–1.10) | 0.144 | 0.99 (0.83–1.18) | ||
| Including alcohol | N cases | 77 | 98 | 42 | 217 | 48 | 127 | 42 | 217 | |||
| HRfully adjusted (95% CI) | 1.00 | 0.94 (0.68–1.30) | 0.74 (0.49–1.13) | 0.208 | 0.92 (0.77–1.09) | 1.00 | 1.47 (1.02–2.11) | 0.90 (0.58–1.41) | 0.342 | 0.97 (0.82–1.14) | ||
Abbreviations: aMED, alternate Mediterranean diet score; mMED, modified Mediterranean diet score; NLCS, Netherlands Cohort Study; n, number of subjects; PY, person‐years in the (sub)cohort; HR, hazard ratio; CI, confidence interval; EPIC‐NL, the Dutch cohort of the European Prospective Investigation into Cancer and Nutrition; EPIC, European Prospective Investigation into Cancer and Nutrition; CPAI, Cambridge Physical Activity Index.
The highest score category of the aMED/mMED including alcohol was defined as 6–9 points.
Continuous HRs were estimated per two‐point increment in score.
The age‐adjusted model was adjusted for age at baseline (years).
The fully adjusted model was in addition to 3 adjusted for cigarette smoking status (never, former, current), cigarette smoking frequency (cigarettes smoked per day, centered), cigarette smoking duration (years, centered), body mass index (kilograms per meter2), daily energy intake (kilocalories), alcohol consumption (grams per day), history of diabetes (no, yes), family history of pancreatic cancer (no, yes), highest level of education (primary school or lower vocational, secondary school or medium vocational, higher vocational or university), and nonoccupational physical activity (≤30, >30‐ ≤60, >60‐ ≤90, >90 minutes per day).
This model was adjusted for the same variables as 4 with the exception of alcohol consumption.
The age‐adjusted model was adjusted for age at baseline (years) and cohort (EPIC‐Prospect, EPIC‐MORGEN).
The fully adjusted model was in addition to 6 adjusted for cigarette smoking status (never, former, current), pack‐years of cigarette smoking (pack‐years, centered), body mass index (kilograms per meter2), daily energy intake (kilocalories), alcohol consumption (grams per day), history of type 2 diabetes (no, yes), highest level of education (primary school or lower vocational, secondary school or medium vocational, higher vocational or university), and total physical activity (CPAI, missings imputed: inactive, moderately inactive, moderately active, active).
This model was adjusted for the same variables as 7 with the exception of alcohol consumption.
Study‐specific effect estimates were pooled using the DerSimonian and Laird random‐effects model.