Cohort study of threshold dose-response association between alcohol consumption and risk of young-onset pancreatic cancer in South Korea

The incidence of youn-onset pancreatic cancer has increased rapidly. A nation-wide cohort study in South Korea evaluated the association between alcohol consumption and rhe risk of incident young-onset pancreatic cancer. A cohort of 6,263,770 individuals aged 20 to 39 years who underwent national health screening between 2009 and 2012 was followed until December 2020. Heavy alcohol consumption was defined as ≥ 30 g/day for men and ≥ 16 g/day for women. A total of 1515 cases of young-onset pancreatic cancer were identified. The cumulative incidence was consistently higher among heavy drinkers compared with nondrinkers or light-to-moderate drinkers (p<0.001). Heavy alcohol consumption was significantly associated with an increased risk of young-onset pancreatic cancer (aHR 1.19; 95% CI 1.004-1.42), whereas light-to-moderate consumption was not (1.04; 0.92-1.17). In addition, alcohol consumption ≥ 3 times per week was associated with an increased risk (aHR 1.23; 95% CI 1.01-1.51). No significant interactions were observed across most subgroups, including age, sex, obesity, smoking status, diabetes, and pancreatitis (all p for interaction ≥ 0.05), except for physical activity (p=0.011). The authors conclude that heavy alcohol consumption was significantly associated with an increased risk of young-onset pancreatic cancer in a threshold dose-response manner.