Annual Meeting of the NCI Cohort Consortium (Abstract Submission): Submission #2

Presenter Information
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First Name: Yilda
Middle Initial: G.
Last Name: Macias
Degree(s): M.P.H.
Position/Title/Career Status: PhD Candidate
Organization: Department of Epidemiology, University of Washington School of Public Health; Public Health Sciences Division, Fred Hutchinson Cancer Center
Email: ymacia29@uw.edu

Additional Authors
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List of Additional Authors:
- First Name: Katie
  Last Name: O'Brien
  Degrees: Ph.D, MSPH
  Affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences
- First Name: Amanda
  Last Name: Phipps
  Degrees: Ph.D., M.P.H.
  Affiliation: Department of Epidemiology, University of Washington School of Public Health; Public Health Sciences Division, Fred Hutchinson Cancer Center
- First Name: Caroline
  Last Name: Um
  Degrees: Ph.D., M.P.H., RD
  Affiliation: Population Science, American Cancer Society
- First Name: Nathalie
  Last Name: Kliemann
  Degrees: Ph.D.
  Affiliation: Division of Genetics and Epidemiology, The Institute of Cancer Research
- First Name: Dale
  Last Name: Sandler
  Degrees: Ph.D., M.P.H.
  Affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences
- First Name: Martin
  Last Name: Lajous
  Degrees: M.D., ScD
  Affiliation: Center for Research on Population Health, National Institute of Public Health, Mexico;  Department of Global Health and Population, Harvard T.H. Chan School of Public Health
- First Name: Montserrat
  Last Name: Garcia-Closas
  Degrees: M.D., M.P.H., DrPH
  Affiliation: Division of Genetics and Epidemiology, The Institute of Cancer Research
- First Name: Amy
  Last Name: Berrington de Gonzalez
  Degrees: Ph.D.
  Affiliation: Division of Genetics and Epidemiology, The Institute of Cancer Research
- First Name: Holly
  Last Name: Harris
  Degrees: ScD, M.P.H.
  Affiliation: Department of Epidemiology, University of Washington School of Public Health; Public Health Sciences Division, Fred Hutchinson Cancer Center


Abstract Information
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Abstract Title: Polyendocrine metabolic ovarian syndrome and pancreatic cancer risk: A pooled analysis across four prospective cohorts
Abstract:
Background: Despite sharing several risk factors, the association between pancreatic cancer and polyendocrine metabolic ovarian syndrome (PMOS), a common endocrinopathy affecting 8-13% of reproductive-aged individuals, remains understudied. Insulin resistance, reported in 35-80% of individuals with PMOS and compounded by obesity and type 2 diabetes, represents one plausible shared mechanism. Three retrospective studies reported a positive association between PMOS and pancreatic cancer, but findings were limited by small sample sizes, single-timepoint covariate assessment, and inconsistent exposure classification.

Methods: We will utilize participant data from over 400,000 women across four prospective cohorts: the Sister Study (SIS), the Cancer Prevention Study-3 (CPS-3), the Mexican Teachers Cohort (MTC), and the Generations Study (GS). Incident pancreatic cancers were identified via self-reports, registry linkage, and mortality records. To capture a broader range of PMOS presentations, we will consider four exposure definitions: self-reported PMOS, menstrual cycle irregularity (MCI), either condition, or both conditions. Pooled logistic regression with one-year intervals will be used to estimate odds ratios and 95% confidence intervals, adjusting for time-varying covariates selected a priori based on established PMOS and pancreatic cancer associations. Cohort-specific estimates will be meta-analyzed to assess heterogeneity prior to pooling. 

Results: Cohort-specific analyses have been completed for SIS and CPS-3. In SIS, all four exposures showed suggestively positive associations with pancreatic cancer risk (OR range = 1.33 – 1.43). In CPS-3, PMOS and the combined exposure could not be evaluated due to low numbers of PMOS-exposed pancreatic cancer cases; associations were null to weakly positive across MCI and either condition (OR range = 1.07 – 1.12). 

Discussion: To our knowledge, this will provide the first prospective evaluation of PMOS and pancreatic cancer risk. Findings may inform risk stratification efforts for individuals with PMOS, a population disproportionately burdened by metabolic comorbidities and underrepresented in epidemiologic research.