{"doi":"10.1371/journal.pmed.1004590","title":"Alcohol intake and pancreatic cancer risk: An analysis from 30 prospective studies across Asia, Australia, Europe, and North America","abstract":"BACKGROUND: Alcohol is a known carcinogen, yet the evidence for an association with pancreatic cancer risk is considered as limited or inconclusive by international expert panels. We examined the association between alcohol intake and pancreatic cancer risk in a large consortium of prospective studies. METHODS AND FINDINGS: Population-based individual-level data was pooled from 30 cohorts across four continents, including Asia, Australia, Europe, and North America. A total of 2,494,432 participants without cancer at baseline (62% women, 84% European ancestries, 70% alcohol drinkers [alcohol intake ≥ 0.1 g/day], 47% never smokers) were recruited between 1980 and 2013 at the median age of 57 years and 10,067 incident pancreatic cancer cases were recorded. In age- and sex-stratified Cox proportional hazards models adjusted for smoking history, diabetes status, body mass index, height, education, race and ethnicity, and physical activity, pancreatic cancer hazard ratios (HR) and 95% confidence intervals (CI) were estimated for categories of alcohol intake and in continuous for a 10 g/day increase. Potential heterogeneity by sex, smoking status, geographic regions, and type of alcoholic beverage was investigated. Alcohol intake was positively associated with pancreatic cancer risk, with HR30-to-<60 g/day and HR≥60 g/day equal to 1.12 (95% CI [1.03,1.21]) and 1.32 (95% CI [1.18,1.47]), respectively, compared to intake of 0.1 to <5 g/day. A 10 g/day increment of alcohol intake was associated with a 3% increased pancreatic cancer risk overall (HR: 1.03; 95% CI [1.02,1.04]; pvalue < 0.001) and among never smokers (HR: 1.03; 95% CI [1.01,1.06]; pvalue = 0.006), with no evidence of heterogeneity by sex (pheterogeneity = 0.274) or smoking status (pheterogeneity = 0.624). Associations were consistent in Europe-Australia (HR10 g/day = 1.03, 95% CI [1.00,1.05]; pvalue = 0.042) and North America (HR10 g/day = 1.03, 95% CI [1.02,1.05]; pvalue < 0.001), while no association was observed in cohorts from Asia (HR10 g/day = 1.00, 95% CI [0.96,1.03]; pvalue = 0.800; pheterogeneity = 0.003). Positive associations with pancreatic cancer risk were found for alcohol intake from beer (HR10 g/day = 1.02, 95% CI [1.00,1.04]; pvalue = 0.015) and spirits/liquor (HR10 g/day = 1.04, 95% CI [1.03,1.06]; pvalue < 0.001), but not wine (HR10 g/day = 1.00, 95% CI [0.98,1.03]; pvalue = 0.827). The differential associations across geographic regions and types of alcoholic beverages might reflect differences in drinking habits and deserve more investigations. CONCLUSIONS: Findings from this large-scale pooled analysis support a modest positive association between alcohol intake and pancreatic cancer risk, irrespective of sex and smoking status. Associations were particularly evident for baseline alcohol intake of at least 15 g/day in women and 30 g/day in men.","journal":"PLoS Medicine","year":2025,"id":509833,"datarank":1.366403992188802,"base_score":3.295836866004329,"endowment":3.295836866004329,"self_citation_contribution":0.4943755299006494,"citation_network_contribution":0.8720284622881527,"self_endowment_contribution":0.4943755299006494,"citer_contribution":0.8720284622881527,"corpus_percentile":84.90755782470798,"corpus_rank":1952,"citation_count":26,"citer_count":22,"citers_with_citation_signal":13,"citers_with_endowment":13,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5899,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":12.5,"fair_percentile":28.767960868236013,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":131778,"name":"Molin Wang","orcid":"0000-0003-1951-8961","position":1,"is_corresponding":false},{"id":108722,"name":"Niki Dimou","orcid":"0000-0003-1678-9328","position":2,"is_corresponding":false},{"id":1365023,"name":"Elmira Ebrahimi","orcid":"0000-0003-0910-3447","position":3,"is_corresponding":false},{"id":246242,"name":"Jeanine M. Genkinger","orcid":"0000-0002-8438-0412","position":4,"is_corresponding":false},{"id":35962,"name":"Hans‐Olov Adami","orcid":"0000-0001-9592-5791","position":5,"is_corresponding":false},{"id":218606,"name":"Demetrius Albanes","orcid":"0000-0001-8330-4293","position":6,"is_corresponding":false},{"id":592347,"name":"A. Babić","orcid":"0000-0002-1444-5604","position":7,"is_corresponding":false},{"id":836098,"name":"Matt J. Barnett","orcid":"0000-0002-1028-1091","position":8,"is_corresponding":false},{"id":318521,"name":"David Bogumil","orcid":"0000-0002-5001-1088","position":9,"is_corresponding":false},{"id":38542,"name":"Hui Cai","orcid":"0000-0002-2388-1694","position":10,"is_corresponding":false},{"id":14678,"name":"Chu Chen","orcid":"0000-0003-2267-8050","position":11,"is_corresponding":false},{"id":104571,"name":"A. Heather Eliassen","orcid":"0000-0002-3961-6609","position":12,"is_corresponding":false},{"id":345249,"name":"Jo L. Freudenheim","orcid":"0000-0002-9301-0499","position":13,"is_corresponding":false},{"id":302470,"name":"Gretchen L. Gierach","orcid":"0000-0002-0165-5522","position":14,"is_corresponding":false},{"id":86230,"name":"Edward L. Giovannucci","orcid":"0000-0002-6123-0219","position":15,"is_corresponding":false},{"id":39449,"name":"Marc J. Gunter","orcid":"0000-0001-5472-6761","position":16,"is_corresponding":false},{"id":302471,"name":"Niclas Håkansson","orcid":"0000-0001-7673-5554","position":17,"is_corresponding":false},{"id":728126,"name":"Mayo Hirabayashi","orcid":null,"position":18,"is_corresponding":false},{"id":302465,"name":"Tao Hou","orcid":"0000-0001-8158-8114","position":19,"is_corresponding":false},{"id":400256,"name":"Brian Z. Huang","orcid":"0000-0001-8645-5142","position":20,"is_corresponding":false},{"id":1365024,"name":"Wen‐Yi Huang","orcid":"0000-0002-5189-9234","position":21,"is_corresponding":false},{"id":394905,"name":"Harindra Jayasekara","orcid":"0000-0002-2453-0183","position":22,"is_corresponding":false},{"id":304436,"name":"Michael E. Jones","orcid":"0000-0001-7479-3451","position":23,"is_corresponding":false},{"id":6219,"name":"Verena Katzke","orcid":"0000-0002-6509-6555","position":24,"is_corresponding":false},{"id":260003,"name":"Woon‐Puay Koh","orcid":"0000-0002-5674-6341","position":25,"is_corresponding":false},{"id":104605,"name":"James V. Lacey","orcid":"0000-0002-4560-8592","position":26,"is_corresponding":false},{"id":407612,"name":"Ylva Trolle Lagerros","orcid":"0000-0001-6816-7577","position":27,"is_corresponding":false},{"id":340015,"name":"Susanna C. Larsson","orcid":"0000-0003-0118-0341","position":28,"is_corresponding":false},{"id":240805,"name":"Linda M. Liao","orcid":"0000-0002-1923-5294","position":29,"is_corresponding":false},{"id":789652,"name":"Kenneth Lo","orcid":"0000-0003-4624-2737","position":30,"is_corresponding":false},{"id":275427,"name":"Erikka Loftfield","orcid":"0000-0002-3573-8748","position":31,"is_corresponding":false},{"id":291313,"name":"Robert J. MacInnis","orcid":"0000-0002-1627-5047","position":32,"is_corresponding":false},{"id":21911,"name":"Satu Männistö","orcid":"0000-0002-8668-3046","position":33,"is_corresponding":false},{"id":339564,"name":"Marjorie L. McCullough","orcid":"0000-0003-3025-6341","position":34,"is_corresponding":false},{"id":302473,"name":"Anthony B. Miller","orcid":"0000-0001-5174-3515","position":35,"is_corresponding":false},{"id":34653,"name":"Roger L. Milne","orcid":"0000-0001-5764-7268","position":36,"is_corresponding":false},{"id":348016,"name":"Steven C. Moore","orcid":"0000-0002-8169-1661","position":37,"is_corresponding":false},{"id":104569,"name":"Lorelei A. Mucci","orcid":"0000-0002-2551-4927","position":38,"is_corresponding":false},{"id":730956,"name":"Marian L Neuhouser","orcid":null,"position":39,"is_corresponding":false},{"id":790203,"name":"Alpa V Patel","orcid":"0000-0001-8834-9896","position":40,"is_corresponding":false},{"id":218634,"name":"Elizabeth A. Platz","orcid":"0000-0003-3676-8954","position":41,"is_corresponding":false},{"id":302474,"name":"Anna E. Prizment","orcid":"0000-0001-5924-6871","position":42,"is_corresponding":false},{"id":302475,"name":"Kim Robien","orcid":"0000-0002-2120-2280","position":43,"is_corresponding":false},{"id":243124,"name":"Thomas E. 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Stolzenberg‐Solomon","orcid":"0000-0003-3698-7006","position":53,"is_corresponding":false},{"id":243118,"name":"Cynthia A. Thomson","orcid":"0000-0003-3645-7048","position":54,"is_corresponding":false},{"id":39584,"name":"Anne Tjønneland","orcid":"0000-0003-4385-2097","position":55,"is_corresponding":false},{"id":286048,"name":"Caroline Y. Um","orcid":"0000-0001-5449-6230","position":56,"is_corresponding":false},{"id":302463,"name":"Piet A. van den Brandt","orcid":"0000-0001-8781-8099","position":57,"is_corresponding":false},{"id":251141,"name":"Kala Visvanathan","orcid":"0000-0002-0582-8005","position":58,"is_corresponding":false},{"id":386153,"name":"Sophia Wang","orcid":"0000-0003-2597-9393","position":59,"is_corresponding":false},{"id":388290,"name":"Renwei Wang","orcid":"0000-0001-8871-7054","position":60,"is_corresponding":false},{"id":22889,"name":"Elisabete Weiderpass","orcid":"0000-0003-2237-0128","position":61,"is_corresponding":false},{"id":240083,"name":"Stephanie J. 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A bare URL is not persistent: it is the single most common cause of a dead data link five years after publication.","anchors":["yes","partial","no"],"verdict":"no","current":0.0,"evidence":null,"why":"No persistent identifier (DOI, Handle, ARK, or repository accession) is given for the dataset.","gain":16.67,"priority":"essential","scored":true},{"key":"f_repository_named","dimension":"F","label":"Named repository","action":"Deposit the data in a repository registered in re3data/FAIRsharing (a domain repository such as GEO, SRA, dbGaP, PRIDE, or a generalist such as Zenodo, Dryad, Dataverse) and name it explicitly in the paper. A lab website is not an archive: it has no retention commitment and no accession.","anchors":["yes","partial","no"],"verdict":"no","current":0.0,"evidence":null,"why":"No repository is named as the holder of the data; the data are available upon request from the consortium. [majority verdict 'no' (4/5 passes agreed)]","gain":16.67,"priority":"essential","scored":true},{"key":"r_reuse_license","dimension":"R","label":"Reuse licence","action":"Attach a standard, machine-readable open licence to the deposit — CC0 or CC BY, which is what Horizon Europe and most funders expect — and print the licence identifier in the paper. 'Free to use' is not a licence: it grants nothing a reuser's institution can rely on.","anchors":["yes","partial","no"],"verdict":"no","current":0.0,"evidence":null,"why":"No licence for the data is mentioned; the CC0 license applies to the article only. [majority verdict 'no' (4/5 passes agreed)]","gain":16.67,"priority":"essential","scored":true},{"key":"a_data_openly_accessible","dimension":"A","label":"Access route free of preconditions","action":"Remove the precondition or justify it. Release the data at publication with no embargo, no registration wall, and no approval step — NIH's zero-embargo public- access rule (NOT-OD-25-101) has already made 'available at publication' the federal baseline for the article; the data should not lag behind it.","anchors":["yes","partial","no"],"verdict":"partial","current":0.5,"evidence":"The sharing of data will be governed by executed data use agreements between the home institution of each cohort studies and the Harvard T.H. Chan School of Public Health, as well as approval from lead investigators for each cohort and/or the cohort study’s leadership.","why":"The access route carries a stated precondition of a data use agreement and approval, which is a specified followable process. [majority verdict 'partial' (4/5 passes agreed)]","gain":8.33,"priority":"essential","scored":true},{"key":"f_dataset_cited","dimension":"F","label":"Dataset formally cited","action":"Cite the dataset in the reference list like a publication — creator, year, title, repository, DOI/accession — and cite it in-text where it is used. Only a reference- list entry is machine-readable to Crossref/DataCite, and only a citation lets the data earn credit.","anchors":["yes","partial","no"],"verdict":"no","current":0.0,"evidence":null,"why":"No identifier for the dataset appears in the reference list or body text.","gain":8.33,"priority":"important","scored":true},{"key":"i_open_nonproprietary_format","dimension":"I","label":"Open file format","action":"Release the data in an open, community-standard format (CSV/TSV, JSON, HDF5, NetCDF, FASTQ, VCF, NIfTI…) instead of — or alongside — any proprietary or instrument-native format, and name the format in the paper. A dataset that needs a €2,000 licence to open is not reusable.","anchors":["yes","partial","no"],"verdict":"no","current":0.0,"evidence":null,"why":"No file format is named for the released data.","gain":8.33,"priority":"important","scored":true},{"key":"x_code_availability","dimension":"R","label":"Analysis code available","action":"Publish the analysis code in a public forge, archive a tagged release with a DOI (Zenodo/Software Heritage), and cite that DOI in the paper. NIH DMS Element 2 asks for the tools and code, not only the data — and 'available on request' is not a locator.","anchors":["yes","partial","no"],"verdict":"no","current":0.0,"evidence":"Statistical programs can be made available upon request to the corresponding author.","why":"The code is available only upon request to a person, not via a machine-resolvable locator.","gain":8.33,"priority":"important","scored":true},{"key":"r_versioning","dimension":"R","label":"Snapshot identified","action":"Version the deposit and cite the exact version analysed (a version-specific DOI, or an accession with its version suffix). A reader reproducing your work against 'the current release' is reproducing it against a different dataset.","anchors":["yes","partial","no"],"verdict":"no","current":0.0,"evidence":null,"why":"No version token or date is provided to identify a specific snapshot of the data.","gain":4.17,"priority":"useful","scored":true},{"key":"f_data_availability_statement","dimension":"F","label":"Data-availability statement","action":"Replace the statement with the repository template: name the repository and give the accession or DOI (Colavizza category 3). This is the only DAS class associated with a measured citation advantage; 'available on reasonable request' and 'within the article' are not.","anchors":["yes","partial","no"],"verdict":"partial","current":0.5,"evidence":"Consortium data can be made available upon request to the EPIC website ( https://epic.iarc.who.int/contact-us/ ).","why":"The data availability statement points to a request process, which is Colavizza category 1.","gain":0.0,"priority":"essential","scored":false},{"key":"f_discovery_metadata","dimension":"F","label":"Description of the dataset as an object","action":"Add a 'Data Records' section: itemise every file in the deposit and every variable or sample it holds, with counts and units. Describe the dataset as an object in its own right, not as a by-product of the findings — this is what makes it discoverable to someone who is not looking for your paper.","anchors":["yes","partial","no"],"verdict":"no","current":0.0,"evidence":"The total study sample consisted of 2,494,432 participants (62% women, 70% alcohol drinkers, 47% never smokers, 64% alcohol drinkers among never smokers) in 30 studies, recruited between 1980 and 2013 with a median age of 57 years.","why":"The dataset is described in running prose without an itemised inventory. [downgraded to 'no' — no verifiable quote from the paper] [majority verdict 'no' (3/5 passes agreed)]","gain":0.0,"priority":"essential","scored":false},{"key":"a_access_conditions_stated","dimension":"A","label":"Access level labelled","action":"State the access level in words, using the standard vocabulary: 'These data are open access' / 'These data are controlled access'. A reader — and a harvester — should not have to infer the access level from the presence of a download link.","anchors":["yes","partial","no"],"verdict":"partial","current":0.5,"evidence":"Consortium data can be made available upon request to the EPIC website ( https://epic.iarc.who.int/contact-us/ ). The sharing of data will be governed by executed data use agreements between the home institution of each cohort studies and the Harvard T.H. Chan School of Public Health, as well as approval from lead investigators for each cohort and/or the cohort study’s leadership. Statistical programs can be made available upon request to the corresponding author.","why":"The paper describes the access process (request, DUA, approvals) but does not apply an explicit access-level label. [majority verdict 'partial' (4/5 passes agreed)]","gain":0.0,"priority":"important","scored":false},{"key":"i_community_standard_vocabulary","dimension":"I","label":"Community standard / vocabulary","action":"Adopt and NAME your domain's data standard — the minimum-information checklist, metadata schema, or ontology your community uses (MIAME/MINSEQE, ISA-Tab, BIDS, an OBO ontology, HL7 FHIR/OMOP) — and say which one you followed. A reporting checklist standardises your paper; it does nothing for your data.","anchors":["yes","partial","no"],"verdict":"partial","current":0.5,"evidence":"This study is reported as per the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline ( S1 Checklist ).","why":"The only named standard is a manuscript reporting guideline (STROBE), not a data or metadata standard.","gain":0.0,"priority":"important","scored":false},{"key":"r_provenance_methods","dimension":"R","label":"Provenance of the data","action":"Name the instruments, kits, and software — with versions — that produced the data, not just the verbs. 'Reads were aligned' is not provenance; 'aligned with STAR v2.7.9a to GRCh38' is, because someone else can rerun it.","anchors":["yes","partial","no"],"verdict":"no","current":0.0,"evidence":"Individual-level data from 30 cohorts were pooled and harmonized.","why":"The processing is described in generic terms without naming specific instruments, kits, or software versions. [downgraded to 'no' — no verifiable quote from the paper] [majority verdict 'no' (4/5 passes agreed)]","gain":0.0,"priority":"important","scored":false},{"key":"r_documentation_codebook","dimension":"R","label":"Documentation / codebook","action":"Ship a README and a data dictionary IN the deposit — every file, every variable, its units, its allowed values, its missing-value codes. It is the cheapest single thing that makes a dataset usable by someone who was not in the lab, and a table buried in the article does not travel with the data.","anchors":["yes","partial","no"],"verdict":"no","current":0.0,"evidence":null,"why":"No documentation object (README, codebook, etc.) is mentioned as accompanying the data. [majority verdict 'no' (4/5 passes agreed)]","gain":0.0,"priority":"important","scored":false},{"key":"i_qualified_references","dimension":"I","label":"Identifiers for the resources the data depend on","action":"Cite by identifier every resource the data depend on — the source datasets' accessions, the reference build (GRCh38 / GCA_000001405.28), the cohort application number, the code DOI — and register those relations on the dataset record (IsDerivedFrom, IsSupplementTo). A name is not a link: it cannot be resolved, versioned, or followed by a machine.","anchors":["yes","partial","no"],"verdict":"no","current":0.0,"evidence":null,"why":"No identifier for any external resource (e.g., source dataset, reference genome) is provided.","gain":0.0,"priority":"useful","scored":false},{"key":"a_timeline_retention","dimension":"A","label":"Availability timing & retention","action":"State when the data become available AND how long they will be retained — cite the repository's preservation policy. NIH DMS Element 4 asks for both; most papers give neither.","anchors":["yes","partial","no"],"verdict":"no","current":0.0,"evidence":null,"why":"The paper does not mention any retention period or persistence commitment for the data.","gain":0.0,"priority":"useful","scored":false}],"suggestions":["Mint or cite a persistent identifier for the dataset — a repository DOI or an accession from a registered repository — and print it in the paper. A bare URL is not persistent: it is the single most common cause of a dead data link five years after publication.","Deposit the data in a repository registered in re3data/FAIRsharing (a domain repository such as GEO, SRA, dbGaP, PRIDE, or a generalist such as Zenodo, Dryad, Dataverse) and name it explicitly in the paper. A lab website is not an archive: it has no retention commitment and no accession.","Attach a standard, machine-readable open licence to the deposit — CC0 or CC BY, which is what Horizon Europe and most funders expect — and print the licence identifier in the paper. 'Free to use' is not a licence: it grants nothing a reuser's institution can rely on.","Remove the precondition or justify it. Release the data at publication with no embargo, no registration wall, and no approval step — NIH's zero-embargo public- access rule (NOT-OD-25-101) has already made 'available at publication' the federal baseline for the article; the data should not lag behind it.","Cite the dataset in the reference list like a publication — creator, year, title, repository, DOI/accession — and cite it in-text where it is used. Only a reference- list entry is machine-readable to Crossref/DataCite, and only a citation lets the data earn credit."],"model":"deepseek/deepseek-v4-flash","agent_version":"fair_agent_v8","fulltext_source":"epmc_xml"},"fair_model":"deepseek/deepseek-v4-flash","fair_agent_version":"fair_agent_v8","fair_fulltext_source":"epmc_xml","fair_has_llm":true,"fair_computed_at":"2026-07-20T11:41:57.439008Z","clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}