Abstract 854: Dietary quality indexes and risk of pancreatic cancer: Findings from a prospective cohort study
Authors: Luu Hung N. , Paragomi Pedram , Jin Aizhen , Wang Renwei , Neelakantan Nithya , van Dam Rob M. , Brand Randall E. , Koh Woon-Puay , Yuan Jian-Min 
Published: July 2021

Abstract
Background. Dietary quality index represents a long-term dietary intake of nutritive and non-nutritive compounds. Therefore, it would be more informative for evaluating the association between dietary intake and health outcomes, including pancreatic cancer, in different populations with distinct dietary habits and patterns. Limited research has been conducted on the effect of dietary quality index (DQI) on pancreatic cancer risk in Asian populations.
Methods. Using data from Singapore Chinese Health Study, a prospective cohort study of 63,257 Chinese men and women aged 45-74 at enrollment during 1993-1998, we created four diet-quality index scores: the Alternative Health Eating Index-2010 (AHEI-2010), alternate Mediterranean Diet (aMED), Dietary Approaches to Stop Hypertension (DASH) and Heathy Diet Indicator (HDI) based on the baseline information collected using validated semi-quantitative food frequency questionnaire. After a mean 17 years of follow-up, 316 participants developed pancreatic cancer. The Cox proportional hazard regression method was used to estimate hazard ratio (HR) and 95% confidence interval (CI) for pancreatic cancer in relation to different levels of these DQI scores.
Results. High scores of AHEI-2010, aMED and DASH were associated with lower risk of pancreatic cancer (all Ptrend&lt;0.05). Compared with the lowest quartile, HRs (95% CIs) of pancreatic cancer for the highest quartiles of AHEI-2010, aMED and DASH were 0.65 (0.46-0.90), 0.60 (0.41-0.89), and 0.69 (0.48-0.98), respectively, after adjustment for age, sex, body mass index, alcohol intake, tobacco smoking, and history of diabetes. We did not find a discernable heterogeneity in these dietary quality indexes-pancreatic cancer risk associations by body mass index levels or status of diabetes or smoking.
Conclusion. High quality diet is significantly associated with reduced risk of pancreatic cancer. The consistent results across different DQIs support the notion that adherence to a healthy diet may lower the risk of pancreatic cancer, suggesting that dietary modification may be a cost-effective approach for primary prevention of pancreatic cancer.
Funding: The Singapore Chinese Health Study was supported by the National Institutes of Health (NIH) of the United States (grants # R01 CA144034 and UM1 CA182876). HN Luu is partially supported by the University of Pittsburgh Medical Center Hillman Cancer Center start-up grant. P Paragomi was supported by the NIH T32CA186873 training grant in cancer epidemiology and prevention; W-P Koh was partially supported by the National Medical Research Council, Singapore (NMRC/CSA/0055/2013).
Citation Format: Hung N. Luu, Pedram Paragomi, Aizhen Jin, Renwei Wang, Nithya Neelakantan, Rob M. van Dam, Randall E. Brand, Woon-Puay Koh, Jian-Min Yuan. Dietary quality indexes and risk of pancreatic cancer: Findings from a prospective cohort study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 854.