Plant-based Diet Index and Risk of Pancreatic Cancer: Findings from a Prospective Cohort Study

Abstract

Background: Data on the association between the plant-based diet and pancreatic cancer is sparse. We, therefore, examined associations for plant-based dietary indices (PDI), healthy PDI (hPDI) and unhealthy PDI (uPDI) with pancreatic cancer risk. Methods: We used data from the Singapore Chinese Health Study, a prospective cohort study of 63,275 participants aged 45-74 living in Singapore who were recruited during 1993-1998 period. The three plant-based dietary scores were calculated from the semi-quantitative food frequency questionnaire that was collected at the baseline. We identified pancreatic cancer cases using record linkage with the Singapore Cancer Registry. Cox proportional hazard regression method was used to generate hazard ratios (HRs) and 95% confidence intervals (CIs) for pancreatic cancer in relation with PDI, hPDI and uPDI scores, adjusted for potential confounders. Results: After 17.6 years of follow-up, we identified 316 pancreatic cancer cases. uPDI was associated with increased risk of pancreatic cancer with a dose-response trend (HRper-SD increment=1.20, 95% CI: 1.06-1.37). The adjusted HRs (95% CIs) for quartiles 2, 3, and 4 relatives to quartile 1 of uPDI were 1.32 (0.94-1.86), 1.22 (0.86-1.71), and 1.68 (1.18-2.39), respectively (P¬trend=0.01). Null association was found for PDI and hPDI with pancreatic cancer risk. Conclusions: We showed that unhealthy PDI was associated with increased risk of pancreatic cancer. Impact: Our results have public health implications for primary prevention against pancreatic cancer development, one of the deadliest malignancies worldwide.