Abstract 2304: Plant-based dietary pattern and risk of pancreatic cancer: Findings from the Singapore Chinese Health Study

Abstract Background: Pancreatic cancer is one of the leading causes of cancer-related death worldwide, with approximately 460, 000 new cases and more than 430, 000 deaths yearly. While most common cancers showed a declined trend in incidence, the incidence rate of pancreatic cancer has increased steadily by 1.5% per year during the past three decades. Established risk factors for pancreatic cancer are tobacco smoking, obesity, type 2 diabetes, and chronic pancreatitis. It is imperative to note that these established risk factors collectively account for less than 50% of pancreatic cancer burden. Recently, plant-based diets have received a significant attention due to their potential benefits to health outcomes, including cancer. The plant-based dietary indices (PDI) include total and healthful PDI (hPDI) and unhealthy PDI (uPDI), which were based on overall intake and sub-categories of food items that deem to be “healthfulness” and/or “unhealthfulness” to better account for the quality of plant foods, Limited number of prospective epidemiological studies have examined the association between PDI and pancreatic cancer risk. We, therefore, prospectively evaluated the associations for PDI, hPDI and uPDI scores with the risk of developing pancreatic cancer. Methods: The current analysis 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 (i.e., PDI, hPDI and uPDI) were derived from the semi-quantitative food frequency questionnaire at baseline. The incident cases of pancreatic cancer were identified through record linkage analysis with the nationwide Singapore Cancer Registry. Cox proportional hazard regression method was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for pancreatic cancer in relation with PDI, hPDI and uPDI scores, adjusted for potential confounding factors. Results: After 17.6 years of follow-up, we identified 316 incident cases of pancreatic cancer. While there was a null association for total PDI or hPDI with risk of pancreatic cancer, uPDI was found to be associated with increased risk of pancreatic cancer. The respective HRs (95% CIs) for quartiles 2, 3, and 4 (the highest quartile) relative to quartile 1 of uPDI were 1.07 (0.75-1.52), 0.86 (0.63-1.24), and 1.61 (1.13-2.28), respectively (Ptrend=0.02). Conclusions: Our findings showed that higher level of unhealthy plant-based dietary index was associated with increased risk of pancreatic cancer. Our results have public health implications for primary prevention against the development of pancreatic cancer, a malignancy among a few with unimproved survival rate during the past four decades. Citation Format: Yen Thi-Hai Pham, Renwei Wang, Randall E. Brand, Tin C. Nguyen, Jian-Min Yuan, Hung N. Luu. Plant-based dietary pattern and risk of pancreatic cancer: Findings from the Singapore Chinese Health Study. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 2304.