Indiana University-Purdue University Indianapolis (IUPUI) / Pancreatic cancer is the third leading cause of cancer-related deaths and is
projected to rank second by 2030 in the United States. However, the etiology of this
malignancy remains elusive, with family history, chronic pancreatitis, type 2 diabetes,
and cigarette smoking as only established risk factors. Therefore, it is urgent and
important to identify risk factors, especially modifiable ones (e.g. diet), for the primary
prevention of this lethal disease. In this dissertation, we have investigated the associations
of mineral intake, dietary quality, and body adiposity with the risk of pancreatic cancer
among participants in the Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO)
Screening Trial. Calcium, magnesium, and phosphorus are essential minerals that
modulate energy metabolism and glucose homeostasis and may thus be involved in
pancreatic carcinogenesis. In the first manuscript, we found that total calcium intake was
associated with a reduced risk of pancreatic cancer. In addition, a significant linear
inverse association was observed for total magnesium intake. The Healthy Eating Index,
2015 (HEI-2015) and the Dietary Quality Index- revised (DQI-R) have been developed to
assess the overall quality or patterns of diet. In the second manuscript, we did not find
significant associations between HEI-2015 or DQI-R scores and pancreatic cancer risk.
However, a higher intake of some score components (i.e., calcium, vegetables, and whole
grains) conferred a lower risk. Although mounting biological mechanisms have linked overweight and obesity to the development of pancreatic cancer, it is largely unclear
whether prediagnostic body mass index (BMI) trajectory is associated with the risk of
this disease. In the third manuscript, we revealed that prediagnostic adulthood BMI
trajectory was not associated with pancreatic cancer risk, but a suggestively or
significantly increased risk were identified for individuals who were overweight at age 20
or obese at age 50, compared with those who had a normal weight at the two respective
time points. Taken together, the findings of research presented in this dissertation
contribute to an improved understanding of the crucial roles of diet and adiposity in the
etiology of pancreatic cancer, which may offer some new avenues for the prevention of
this intractable malignancy.
| Identifer | oai:union.ndltd.org:IUPUI/oai:scholarworks.iupui.edu:1805/29843 |
| Date | 08 1900 |
| Creators | Hoyt, Margaret Leeann |
| Contributors | Zhang, Jianjun, Song, Yiqing, Gao, Sujuan, O'Palka, Jacquelynn |
| Source Sets | Indiana University-Purdue University Indianapolis |
| Language | en_US |
| Detected Language | English |
| Type | Dissertation |
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