***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Pancreatic cancer is the fourth most common cause of cancer death worldwide with large geographical variation , which implies the contribution of diet and lifestyle in its etiology . We examined the association of meat and fish consumption with risk of pancreatic cancer  in the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) . A total of 477,202 EPIC participants from 10 European countries recruited between 1992 and 2000 were included in our analysis . Until 2008 , 865 nonendocrine pancreatic cancer cases have been observed .  Calibrated relative risks ( RRs ) and 95 % confidence intervals ( CIs ) were computed using multivariable-adjusted Cox hazard regression models . The consumption of red meat ( RR per 50 g increase per day = 1.03 , 95 % CI = 0.93 - 1.14 ) and processed meat ( RR per 50 g increase per day = 0.93 , 95 % CI = 0.71 - 1.23 ) were not associated with an increased pancreatic cancer risk . Poultry consumption tended to be associated with an increased pancreatic cancer risk ( RR per 50 g increase per day = 1.72 , 95 % CI = 1.04 - 2.84 ) ; however , there was no association with fish consumption ( RR per 50 g increase per day = 1.22 , 95 % CI = 0.92 - 1.62 ) . Our results do not support the conclusion of the World Cancer Research Fund that red or processed meat consumption may possibly increase the risk of pancreatic cancer . The positive association of poultry consumption with pancreatic cancer might be a chance finding as it contradicts most previous findings There have been few prospect i ve studies relating diet to pancreatic cancer , with most having fewer than 100 cases and only one examining dietary nutrients . The authors prospect ively examined dietary factors hypothesized to be associated with exocrine pancreatic cancer in the Alpha-Tocopherol , Beta-Carotene Cancer Prevention Study cohort in Finl and . Of the 27,111 male smokers aged 50 - 69 years with complete dietary information , as ascertained from a self-administered dietary history question naire given at baseline ( 1985 - 1988 ) , 163 developed pancreatic cancer from 1985 through November 1997 . Cox proportional hazards models were used to estimate smoking- and age-adjusted hazard ratios and 95 % confidence intervals .  Energy-adjusted butter consumption and saturated fat intake  were positively associated with pancreatic cancer ( highest quintile vs. lowest : hazard ratio ( HR ) = 1.40 , 95 % confidence interval ( CI ) : 0.87 , 2.25 ( p trend = 0.04 ) , and HR = 1.60 , 95 % CI : 0.96 , 2.64 ( p trend = 0.02 ) , respectively ) . Energy intake and energy-adjusted carbohydrate intake  were inversely associated with the disease ( highest quintile vs. lowest : HR = 0.62 , 95 % CI : 0.36 , 1.07 ( p trend = 0.05 ) , and HR = 0.62 , 95 % CI : 0.37 , 1.03 ( p trend = 0.02 ) , respectively ) . These results support the hypothesis that a high intake of saturated fat may increase the risk of pancreatic cancer in smokers , while greater intakes of energy and carbohydrate may reduce the risk Objectives Pancreatic adenocarcinoma has one of the worst survival rates of all the cancers . Established risk factors for this malignancy are smoking , body mass index ( BMI ) and family history of pancreatic cancer . Findings are inconsistent regarding pancreatitis , diabetes , allergies , intake of fruit , vegetables , red meat , alcohol , caffeine , vitamin C , calcium , and folate supplements . Possible pancreatic cancer risk factors were evaluated within the population -based Ontario Pancreas Cancer Study . Methods Pathologically confirmed pancreatic cancer cases ( n = 422 ) were identified from the Ontario Cancer Registry between 2003 and 2007 . Controls ( n = 312 ) were recruited through r and om digit dialing .  Data were collected using self-administered question naires . Multivariate logistic regression was used to obtain odds ratios . Results Smoking , BMI , family history of pancreatic cancer , and caffeine were significantly associated with increased pancreatic cancer risk , while fruit intake and allergies significantly decreased risk . No other significant associations were observed in the multivariate model . Effect modification by smoking status was suggested for caffeine , family history of pancreatic cancer , BMI , and fruit . Conclusions This study further clarifies the association between several lifestyle , dietary and medical history factors , and pancreatic cancer risk , many of which are potentially modifiable . Possible effect modification by smoking status should be further explored in future etiologic studies BACKGROUND Advanced glycation end products ( AGEs ) are a heterogeneous group of compounds present in uncooked foods as well as in foods cooked at high temperatures . AGEs have been associated with insulin resistance , oxidative stress , and chronic inflammation in patients with diabetes . Dietary AGEs are an important contributor to the AGE pool in the body . N(ϵ)-(carboxymethyl)lysine ( CML ) AGE is one of the major biologically and chemically well-characterized AGE markers . The consumption of red meat , which is CML-AGE rich , has been positively associated with pancreatic cancer in men . OBJECTIVES With the use of a published food CML-AGE data base , we estimated the consumption of CML AGE in the prospect i ve NIH-AARP Diet and Health Study and evaluated the association between CML-AGE consumption and pancreatic cancer and the mediating effect of CML AGE on the association between red meat consumption and pancreatic cancer . DESIGN Multivariate Cox proportional hazard regression models were used to estimate HRs and 95 % CIs for pancreatic cancer . RESULTS During an average of 10.5 y of follow-up , we identified 2193 pancreatic cancer cases ( 1407 men and 786 women ) from 528,251 subjects . With the comparison of subjects in the fifth and the first quintiles of CML-AGE consumption , we observed increased pancreatic cancer risk in men ( HR : 1.43 ; 95 % CI : 1.06 , 1.93 , P-trend = 0.003 ) but not women ( HR : 1.14 ; 95 % CI : 0.76 , 1.72 , P-trend = 0.42 ) . Men in the highest quintile of red meat consumption had higher risk of pancreatic cancer ( HR : 1.35 ; 95 % CI : 1.07 , 1.70 ) , which attenuated after adjustment for CML-AGE consumption ( HR : 1.20 ; 95 % CI : 0.95 , 1.53 ) . CONCLUSION Dietary CML-AGE consumption was associated with modestly increased  risk of pancreatic cancer in men and may partially explain the positive association between red meat and pancreatic cancer IMPORTANCE Red meat consumption has been consistently associated with an increased risk of  type 2 diabetes mellitus ( T2DM ) . However , whether changes in red meat intake are related to subsequent T2DM risk remains unknown . OBJECTIVE To evaluate the association between changes in red meat consumption during a 4-year period and subsequent 4-year risk of T2DM in US adults . DESIGN AND SETTING Three prospect i ve cohort studies in US men and women . PARTICIPANTS We followed up 26,357 men in the Health Professionals Follow-up Study ( 1986 - 2006 ) , 48,709 women in the Nurses ' Health Study ( 1986 - 2006 ) , and 74,077 women in the Nurses ' Health Study II ( 1991 - 2007 ) .  Diet was assessed by vali date d food frequency question naires and up date d every 4 years . Time-dependent Cox proportional hazards regression models were used to calculate hazard ratios with adjustment for age , family history , race , marital status , initial red meat consumption , smoking status , and initial and changes in other lifestyle factors ( physical activity , alcohol intake , total energy intake , and diet quality ) . Results across cohorts were pooled by an inverse variance-weighted , fixed-effect meta- analysis . MAIN OUTCOMES AND MEASURES Incident T2DM cases vali date d by supplementary question naires . RESULTS During 1,965,824 person-years of follow-up , we documented 7540 incident T2DM cases . In the multivariate-adjusted models , increasing red meat intake during a 4-year interval was associated with an elevated risk of T2DM during the subsequent 4 years in each cohort ( all P < .001 for trend ) . Compared with the reference group of no change in red meat intake , increasing red meat intake of more than 0.50 servings per day was associated with a 48 % ( pooled hazard ratio , 1.48 ; 95 % CI , 1.37 - 1.59 ) elevated risk in the subsequent 4-year period , and the association was modestly attenuated after further adjustment for initial body mass index and concurrent weight gain ( 1.30 ; 95 % CI , 1.21 - 1.41 ) . Reducing red meat consumption by more than 0.50 servings per day from baseline to the first 4 years of follow-up was associated with a 14 % ( pooled hazard ratio , 0.86 ; 95 % CI , 0.80 - 0.93 ) lower risk during the subsequent entire follow-up through 2006 or 2007 . CONCLUSIONS AND RELEVANCE Increasing red meat consumption over time is associated with an elevated subsequent risk of T2DM , and the association is partly mediated by body weight . Our results add further evidence that limiting red meat consumption over time confers benefits for T2DM prevention Meat contains numerous carcinogens , such as heterocyclic amines , polycyclic aromatic hydrocarbons , and N‐nitroso compounds , which can be derived either from natural food or during the process of food preparation . These carcinogens may increase pancreatic cancer risk . Furthermore , studies in animals showed that polyunsaturated fatty acids , especially linoleic acid , increase pancreatic cancer risk . We examined prospect ively the relation between pancreatic cancer risk and intake of fresh meat , processed meat , fish , eggs , total fat , and different types of fat . The Netherl and s Cohort Study consisted of 120,852 men and women who completed a baseline question naire in 1986 . After 13.3 years of follow‐up , 350 pancreatic cancer cases ( 66 % microscopically confirmed ) were available for analysis . A vali date d 150‐item food‐frequency question naire was used to calculate intake of fresh meat , processed meat , fish , eggs , fat and different types of fat .  No association was found when examining the association between intake of fresh meat , other types of meat , fish , eggs , dietary intake of total fat and different types of fat  and risk of pancreatic cancer . It is important for future studies to investigate the relation between different meat‐cooking methods  and pancreatic cancer . © 2009 High meat consumption has been associated with increased risk of pancreatic cancer in several , although not all , case-control studies . However , prospect i ve data on this relationship are sparse , and the results have been inconsistent . We prospect ively evaluated meat , fish , poultry , and egg consumption in relation to pancreatic cancer incidence in a population -based cohort of 61,433 Swedish women .  Diet was assessed with a food-frequency question naire at baseline ( 1987 - 1990 ) and again in 1997 . Pancreatic cancers were ascertained through linkage to the Swedish Cancer Register . Cox proportional hazards models were used to estimate multivariate hazard ratios with 95 % confidence intervals ( CI ) . During the 941,218 person-years of follow-up , from 1987 through 2004 , 172 incident cases of pancreatic cancer were diagnosed . Long-term red meat consumption ( using data from both dietary question naires ) was positively associated with risk of pancreatic cancer ( p-trend = 0.01 ) , whereas long-term poultry consumption was inversely ( p-trend = 0.04 ) associated with risk . The multivariate hazard ratios for the highest versus the lowest category of consumption were 1.73 ( 95 % CI = 0.99 - 2.98 ) for red meat and 0.44 ( 95 % CI = 0.20 - 0.97 ) for poultry . There were no significant associations with processed meat , fish or egg consumption . Findings from this prospect i ve study suggest that substituting poultry for red meat might reduce the risk of pancreatic cancer BACKGROUND Epidemiological studies report positive associations between high-temperature cooked meat intake and  pancreatic cancer .  We assessed associations between dietary intake of heterocyclic amines ( HCAs ) and benzo(a)pyrene (BaP)-mutagens formed in meat cooked at high temperatures- and incident exocrine pancreatic cancer in a prospect i ve cohort . METHODS The 62 581 subjects r and omized to screening in the Prostate , Lung , Colorectal , and 
    Output:
    
In a systematic review and meta‐ analysis , we found case‐control but not cohort studies to associate consumption of red and processed meat  with risk of pancreatic cancer .
However , in cohort studies , consumption of red and processed meat appeared to increase risk of pancreatic cancer in men but not in women