PLoS Medicine (May 2025)

Alcohol intake and pancreatic cancer risk: An analysis from 30 prospective studies across Asia, Australia, Europe, and North America.

  • Sabine Naudin,
  • Molin Wang,
  • Niki Dimou,
  • Elmira Ebrahimi,
  • Jeanine Genkinger,
  • Hans-Olov Adami,
  • Demetrius Albanes,
  • Ana Babic,
  • Matt Barnett,
  • David Bogumil,
  • Hui Cai,
  • Chu Chen,
  • A Heather Eliassen,
  • Jo L Freudenheim,
  • Gretchen Gierach,
  • Edward L Giovannucci,
  • Marc J Gunter,
  • Niclas Håkansson,
  • Mayo Hirabayashi,
  • Tao Hou,
  • Brian Z Huang,
  • Wen-Yi Huang,
  • Harindra Jayasekara,
  • Michael E Jones,
  • Verena A Katzke,
  • Woon-Puay Koh,
  • James V Lacey,
  • Ylva Trolle Lagerros,
  • Susanna C Larsson,
  • Linda M Liao,
  • Kenneth Lo,
  • Erikka Loftfield,
  • Robert J MacInnis,
  • Satu Männistö,
  • Marjorie L McCullough,
  • Anthony Miller,
  • Roger L Milne,
  • Steven C Moore,
  • Lorelei A Mucci,
  • Marian L Neuhouser,
  • Alpa V Patel,
  • Elizabeth A Platz,
  • Anna Prizment,
  • Kim Robien,
  • Thomas E Rohan,
  • Carlotta Sacerdote,
  • Sven Sandin,
  • Norie Sawada,
  • Minouk Schoemaker,
  • Xiao-Ou Shu,
  • Rashmi Sinha,
  • Linda Snetselaar,
  • Meir J Stampfer,
  • Rachael Stolzenberg-Solomon,
  • Cynthia A Thomson,
  • Anne Tjønneland,
  • Caroline Y Um,
  • Piet A van den Brandt,
  • Kala Visvanathan,
  • Sophia S Wang,
  • Renwei Wang,
  • Elisabete Weiderpass,
  • Stephanie J Weinstein,
  • Emily White,
  • Walter Willett,
  • Alicja Woslk,
  • Brian M Wolpin,
  • Shiaw-Shyuan S Yaun,
  • Chen Yuan,
  • Jian-Min Yuan,
  • Wei Zheng,
  • Paul Brennan,
  • Stephanie A Smith-Warner,
  • Pietro Ferrari

DOI
https://doi.org/10.1371/journal.pmed.1004590
Journal volume & issue
Vol. 22, no. 5
p. e1004590

Abstract

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BackgroundAlcohol is a known carcinogen, yet the evidence for an association with pancreatic cancer risk is considered as limited or inconclusive by international expert panels. We examined the association between alcohol intake and pancreatic cancer risk in a large consortium of prospective studies.Methods and findingsPopulation-based individual-level data was pooled from 30 cohorts across four continents, including Asia, Australia, Europe, and North America. A total of 2,494,432 participants without cancer at baseline (62% women, 84% European ancestries, 70% alcohol drinkers [alcohol intake ≥ 0.1 g/day], 47% never smokers) were recruited between 1980 and 2013 at the median age of 57 years and 10,067 incident pancreatic cancer cases were recorded. In age- and sex-stratified Cox proportional hazards models adjusted for smoking history, diabetes status, body mass index, height, education, race and ethnicity, and physical activity, pancreatic cancer hazard ratios (HR) and 95% confidence intervals (CI) were estimated for categories of alcohol intake and in continuous for a 10 g/day increase. Potential heterogeneity by sex, smoking status, geographic regions, and type of alcoholic beverage was investigated. Alcohol intake was positively associated with pancreatic cancer risk, with HR30-to-ConclusionsFindings from this large-scale pooled analysis support a modest positive association between alcohol intake and pancreatic cancer risk, irrespective of sex and smoking status. Associations were particularly evident for baseline alcohol intake of at least 15 g/day in women and 30 g/day in men.