The Population Attributable Fractions of Pancreatic Cancer Caused by Key Risk Factors (continuation of PLCO-351)

Principal Investigator

Name
Rachael Stolzenberg-Solomon

Degrees
Ph.D., M.P.H., R.D.

Institution
NCI, NIH

Position Title
Senior Investigator

Email
rs221z@nih.gov

About this CDAS Project

Study
PLCO (Learn more about this study)

Project ID
PLCO-2083

Initial CDAS Request Approval
Sep 10, 2026

Title
The Population Attributable Fractions of Pancreatic Cancer Caused by Key Risk Factors (continuation of PLCO-351)

Summary
Pancreatic cancer incidence has been increasing globally and in the US since the early 1990s. The disease is currently the 3rd leading cause of cancer mortality in the United States, but with increasing mortality it is estimated that by 2030 it will become the second leading cancer-related cause of death, after lung. The associations between modifiable lifestyle factors (such as smoking and overweight/obesity) and cancer incidence is well established and previous studies have examined the fractions of cancer incidence that can be attributed to particular lifestyle factors. Previous investigations of population attributable risk for pancreatic cancer have tended to focus upon pancreatic cancer overall which likely parallels the most common pancreatic cancer, pancreatic ductal adenocarcinoma, with population attributable fraction for tobacco smoking to be 11-32% and overweight/obesity to be 11-19%.

Our study seeks to explore the association between smoking, overweight/obesity, alcohol use and diabetes and pancreatic cancer using smoking, BMI, and alcohol use data that has already been collected in the cohort consortium. These relative risks will be used to produce population attributable fractions (PAFs) which will then be applied to SEER data to explore the impact that these exposures have upon the changing rates of pancreatic cancer – our earlier research demonstrated how rates and trends in pancreatic cancer differed by sex, racial/ethnic group and histologic type. If there are adequate numbers, we will also examine associations between smoking, overweight, alcohol and less common pancreatic subtypes (e.g. neuroendocrine cancers) and report associations in a separate paper. We plan to apply the risk estimates to SEER data to calculate PAF in the US.

Aims

Primary aim:
1) To determine the association between smoking, overweight/obesity, alcohol use and diabetes and pancreatic cancer using smoking, BMI, and alcohol use data that has already been collected in the cohort consortium. These relative risks will be used to produce population attributable fractions (PAFs) by histologic subtype which will then be applied to SEER data to explore the impact that these exposures have upon the changing rates of pancreatic cancer – our earlier research demonstrated how rates and trends in pancreatic cancer differed by sex, racial/ethnic group and histologic type.

Secondary aim:
2) If there are adequate numbers, we will examine associations between smoking, overweight, alcohol and less common pancreatic subtypes (e.g. neuroendocrine cancers) and report associations in a separate paper.

Collaborators

Rachael Stolzenberg-Solomon NCI, NIH
JEROME MABIE NCI, NIH
Amparo Gonzalez-Feliciano NCI, NIH