![]() University of Pennsylvania alumni provided the same at baseline in 1962, updating this in 19. Harvard alumni provided information on physical activity and body weight at baseline in 1962 or 1966 and updated this in 1977, 1988, and 1993. Assessment of physical activity and body weight Of the remaining 33 604 subjects, we successfully followed 32 687 (including 2302 women) for pancreatic cancer mortality these represent the subjects for this study. For the present study, we excluded subjects reporting cancer at baseline ( n=601), and those with missing information on age or sex ( n=74) and physical activity, body weight, or height ( n=1645). ![]() In 1962 or 1966, 21 582 Harvard men and 14 342 University of Pennsylvania alumni returned their initial health survey. We have since obtained updated health information via mailed surveys at periodic intervals. The first health survey was mailed to Harvard University alumni in either 1962 or 1966, and University of Pennsylvania alumni in 1962. Subjects were recruited from men matriculating at Harvard University as undergraduates between 19, and men and women matriculating at the University of Pennsylvania as undergraduates and graduates between 19. The College Alumni Health Study is an ongoing study of physical activity and health among men and women in the United States, initiated in 1962. Few data are available, providing the motivation for this study. Owing to these associations, we hypothesised that physical activity and a lean body weight would decrease the risk of pancreatic cancer. Physical inactivity and overweight are associated with abnormal glucose metabolism, including insulin resistance, hyperinsulinaemia, impaired glucose tolerance, and type II diabetes ( Albu and Pi-Sunyer, 1998 Kelley and Goodpaster, 2001). Additionally, a recent study reported that diets rich in foods that raise postprandial glucose levels increase the risk of pancreatic cancer ( Michaud et al, 2002). This is supported by human studies, with a meta-analysis of 20 studies concluding that diabetes mellitus is associated with increased risk ( Everhart and Wright, 1995). Experiments using a hamster model have suggested that insulin and insulin resistance may play a role in the aetiology of pancreatic cancer ( Schneider et al, 2001). Unfortunately, there are few established risk factors, the exception being cigarette smoking ( IARC, 1986). Owing to the grim prognosis, prevention of pancreatic cancer is important. In the United Kingdom, this cancer does not rank in the top 10 for newly diagnosed cases, yet, it is the sixth most common cancer death ( CancerStats, June 2002 September 2002). Pancreatic cancer is a rapidly fatal cancer with 5-year survival of about 4% for all tumours ( Ries et al, 2002), and <1% for nonresectable tumours ( Bramhall et al, 1995).
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