Alcohol consumption and the risk of pancreatic cancer: A systematic review and meta-analysis of cohort studies

  • Jinhui Zhao Canadian Institute for Substance Use Research, University of Victoria, BC, Canada
  • Tim Stockwell Canadian Institute for Substance Use Research, University of Victoria, BC, Canada; Psychology Department, University of Victoria, BC, Canada https://orcid.org/0000-0002-5696-6803
  • Tim Naimi Canadian Institute for Substance Use Research, University of Victoria, BC, Canada; School of Medical Sciences, University of Victoria, BC, Canada https://orcid.org/0000-0001-9849-4413
  • James Clay Canadian Institute for Substance Use Research, University of Victoria, BC, Canada; Department of Community Health and Epidemiology, Dalhousie University, Nova Scotia, Canada https://orcid.org/0000-0002-3392-5099
  • Keegan Lawrence Canadian Institute for Substance Use Research, University of Victoria, BC, Canada
  • Adam Sherk Canadian Institute for Substance Use Research, University of Victoria, BC, Canada; Canadian Centre on Substance Use and Addiction, Ottawa, ON, Canada https://orcid.org/0000-0002-8149-4502
DOI: https://doi.org/10.7895/ijadr.649
Keywords: pancreatic cancer, alcohol, meta-analysis, former drinker bias

Abstract

Objective: Previous reviews have reported inconsistent relationships between alcohol use and risk of pancreatic cancer (PC). We investigated associations between alcohol consumption and PC in a meta-analysis.

Methods: PubMed and Web of Science were searched for cohort studies of alcohol and PC incidence/mortality up to January 1, 2024. Studies were coded for former drinker misclassification, extent of control for confounding, and other study characteristics. Mixed models were used to model the meta-data and calculate the summarized hazard ratio as relative risk (RR) of PC incidence/mortality. Former drinker misclassification and other study-level covariates were examined and controlled using adjustments, quality weighting and stratification.

Results: Thirty-seven cohort studies provided 279 PC incidence/mortality risk estimates for drinkers versus “non-drinkers”. In pooled analyses with and without adjustment for study-level covariates, there was no significant protection at any level, and significantly increased risk at >24 grams/day. Significant dose-response relationships were observed; e.g., there was a 2.4% increase in PC risk for each 10g ethanol/day increment in the adjusted model (P=0.0001). In stratified analyses, studies with former drinking bias showed significantly reduced PC risk for those drinking >14-24g/day and no significant increase in risk for people drinking >24-44g/day; neither finding was observed among studies with reduced former drinker bias.

Conclusion: Alcohol consumption and pancreatic cancer exhibits a dose-response risk relationship; consumption of >24 grams/day is significantly associated with increased risk. Failing to separate former drinkers from lifetime abstainers may yield spurious protective associations at low levels of consumption and may suppress risk estimates at higher levels.

Author Biography

Jinhui Zhao, Canadian Institute for Substance Use Research, University of Victoria, BC, Canada

Canadian Institute for Substance Use Research (CISUR)
Scientist

Published
2026-06-08
How to Cite
Zhao, J., Stockwell, T., Naimi, T., Clay , J., Lawrence , K., & Sherk, A. (2026). Alcohol consumption and the risk of pancreatic cancer: A systematic review and meta-analysis of cohort studies. International Journal of Alcohol and Drug Research. https://doi.org/10.7895/ijadr.649
Issue
Early View Papers and Abstracts
Section
KBS 2025 Conference Issue

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