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Risk: An Umbrella Review of  \nMeta-Analyses of Prospective Observational Studies Xianpeng Qin 1, y, Jing Chen 2, y, Guiqing Jia 1, Zhou Yang 1, *  \n1 Department of Gastrointestinal Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People ’s Hospital, University of Electronic Science and Technology of China, Chengdu, China; 2 Department of Obstetrics and Gynecology, Sichuan Academy of Medical Sciences & Sichuan Provincial People ’s Hospital, University of Electronic Science and Technology of China, Chengdu, China  \n\n| A B S T R A C T |\n| --- |\n| Dietary factors may be associated with the occurrence of pancreatic cancer. This umbrella review aimed to review and grade the evidence for the associations between dietary factors and pancreatic cancer risk. We searched PubMed, EMBASE, Web of Science, Scopus, Cochrane Database of Systematic Reviews, and CINAHL for eligible literature. We included meta-analyses of randomized controlled trials (RCTs) or prospective observational studies. We used AMSTAR-2, a measurement tool to assess systematic reviews, to evaluate the methodological quality of the included meta-analyses. For each association, we calculated the summary effect size, 95% CI, heterogeneity, number of cases, 95% prediction interval, small-study effect, and excess significance bias. The protocol for this review was registered in the PROSPERO database (CRD42022333669). We included 41 meta-analyses of prospective observational studies describing 59 associations between dietary factors and pancreatic cancer risk. None of the retrieved meta-analyses included RCTs. No association was supported by convincing or highly suggestive evidence; however, there was suggestive evidence of a positive association between fructose intake and pancreatic cancer risk. There was weak evidence for an inverse association of nuts intake or adherence to the Mediterranean diet with pancreatic cancer incidence, and for positive associations between a higher intake of red meat or heavy alcohol intake and pancreatic cancer incidence. The remaining 54 associations were nonsignificant. Consistent with the American Institute for Cancer Research review, this umbrella review found that regular consumption of nuts and reduced intake of fructose, red meat, and alcohol were associated with a lower risk of pancreatic cancer. Emerging weak evidence supported an inverse association between adherence to the Mediterranean diet and pancreatic cancer risk. As some associations were rated as weak and most were considered nonsignificant, further prospective studies are needed to investigate the role of dietary factors and risk of pancreatic cancer.\u003Cbr>Keywords: diet, pancreatic cancer, evidence, meta-analyses, umbrella review |\n\nStatement of Significance  \nThis umbrella review goes beyond prior literature in several ways. The expert report published by World Cancer Research Fund and the American Institute for Cancer Research (AICR) in 2018 included data derived from prospective and retrospective studies, with a search strategy until September 2011. However, a considerable number of relevant meta-analyses have been published since 2011, which are included in our review. Of the 41 meta-analyses included in this review, 40 were published after the last AICR review, and 37 had search strategy cutoff dates beyond the previous AICR review. Additionally, we used only prospective studies, which are prone to less confounding than retrospective studies, to assess the robustness of the evidence. Consistent with the AICR review, the results of this review highlight that regular nuts consumption and reduced intake of fructose, red meat, and alcohol were associated with a lower risk of pancreatic cancer. There was an inverse association between adherence to the Mediterranean diet and pancreatic cancer risk, but this association is supported by weak evidence.  \nAbbreviations used: CUP,","cbCaiteOxZCJZeE3","https://ap.wps.com/l/cbCaiteOxZCJZeE3","pdf",666358,14,"English","# Abstract\n# Statement of Significance\n# Abbreviations\n# Introduction","[{\"question\":\"What was the purpose of this umbrella review?\",\"answer\":\"To review and grade evidence for associations between dietary factors and pancreatic cancer risk, using umbrella review methods.\"},{\"question\":\"Which databases and study types were included?\",\"answer\":\"The review searched PubMed, EMBASE, Web of Science, Scopus, Cochrane Database of Systematic Reviews, and CINAHL, and included meta-analyses of RCTs or prospective observational studies.\"},{\"question\":\"What dietary associations were suggested by the review?\",\"answer\":\"Suggestive evidence supported a positive association between fructose intake and pancreatic cancer risk, while weak evidence supported inverse associations for nuts intake and adherence to the Mediterranean diet.\"}]","Dietary Factors and Pancreatic Cancer Risk: An Umbrella Review of Meta-Analyses of Prospective Observational Studies | PDF",1790561408,35]