• Department of Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
• Department of Emergency, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
• Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
• Department of Nephrology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
• Department of Geriatrics, The Fifth People's Hospital of Chengdu, Chengdu, China.
• Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
• Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, China. Electronic address: 305876@hospital.cqmu.edu.cn.
• Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address: gczhong1991@stu.cqmu.edu.cn.

BACKGROUND & AIMS: Type 2 diabetes prevention diet confers a lower risk of type 2 diabetes, which exhibits overlapping mechanisms with pancreatic cancer. We performed a prospective study to examine whether adherence to this dietary pattern is associated with a reduced risk of pancreatic cancer.

METHODS: A population-based cohort of 101,729 American adults was identified. A dietary diabetes risk reduction score was computed to reflect adherence to this dietary pattern, with higher scores representing greater adherence. Cox regression was used to compute hazard ratios (HRs) for pancreatic cancer incidence. Prespecified subgroup analyses were used to identify the potential effect modifiers.

RESULTS: After an average follow-up of 8.86 years (900,871.67 person-years), a total of 402 pancreatic cancer cases were observed. In the fully adjusted model, participants in the highest quartile of dietary diabetes risk reduction score were found to have a reduced risk of pancreatic cancer compared with those in the lowest quartile [HR_{quartiles 4versus1}: 0.62; 95% confidence interval (CI): 0.44, 0.86; P_trend = 0.004], which remained in a series of sensitivity analyses. Subgroup analyses further found that this favorable association was more pronounced in current or former smokers (HR_{quartiles 4versus1}: 0.48; 95% CI: 0.30, 0.77) than in never smokers (HR_{quartiles 4versus1}: 0.71; 95% CI: 0.44, 1.15), although the interaction test did not reach statistical significance (P_interaction = 0.095).

CONCLUSIONS: Greater adherence to type 2 diabetes prevention diet is associated with a lower risk of pancreatic cancer in this US population. More studies are needed to confirm our findings.