Association of Life's Essential 8 Score With Incident Pancreatic Cancer: A Prospective Cohort Study in Shanghai, China

Q: What are the key findings of this study?

High cardiovascular health, defined by a Life's Essential 8 score ≥ 80, was associated with a 61% lower risk of incident pancreatic cancer compared to low cardiovascular health (HR 0.39, 95% CI 0.19-0.82).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cancer-free adults (n=60556). Intervention: High Life's Essential 8 (LE8) score (≥ 80) vs. Low LE8 score (< 50). Primary outcome: Incident pancreatic cancer (HR 0.39, 95% CI 0.19-0.82, p=0.012).

Q: What does this research mean for the field?

High Life's Essential 8 cardiovascular health scores are associated with a significantly lower risk of incident pancreatic cancer compared to low scores. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Liping Yi; Xing Liu; Maryam Zaid; Kexin Zhang; Biying Wang; Yingqi Deng; Minhua Tang; Yonggen Jiang; Genming Zhao

doi:10.1111/cas.70512

August 24, 2026Cancer ScienceOpen Access

Association of Life's Essential 8 Score With Incident Pancreatic Cancer: A Prospective Cohort Study in Shanghai, China

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Key result

High cardiovascular health is linked to ~61% lower incident pancreatic cancer risk.

HR 0.39
95% CI 0.19-0.82
P=0.012
n=60,556

Figures

Graphical abstract published by Cancer Science — Graphical abstract · Published by Cancer Science · CC BY-NC-ND

Why the study?

Higher Life's Essential 8 scores are associated with lower chronic disease risk, but evidence regarding pancreatic cancer in Chinese populations is scarce.

Does high cardiovascular health (Life's Essential 8 score) reduce incident pancreatic cancer in cancer-free adults?

Key Points

To examine the prospective association between cardiovascular health assessed by Life's Essential 8 scores and the risk of incident pancreatic cancer in Chinese adults.
Prospective cohort study analyzing 60,556 cancer-free adults from the Shanghai Suburban Adult Cohort and Biobank followed for a median of 7.4 years (7.44 years).
Cardiovascular health was assessed via Life's Essential 8 (0–100 score; low < 50, moderate 50–79, high ≥ 80), comprising four health behaviors (diet, physical activity, nicotine exposure, sleep) and four health factors (BMI, blood lipids, blood glucose, blood pressure).
Incident pancreatic cancer was identified using cancer registries, hospital systems, and death records, with risk evaluated using multivariable Cox proportional hazards models.
Over follow-up, 200 participants (0.3%, incidence density 46.7 cases per 100,000 person-years) developed pancreatic cancer.
Compared with low cardiovascular health, participants with moderate (HR = 0.65, 95% CI = 0.46–0.92) and high (HR = 0.39, 95% CI = 0.19–0.82) cardiovascular health had lower risks of pancreatic cancer (P for trend = 0.003), with each standard deviation score increase conferring an 18% lower risk (HR = 0.82, 95% CI = 0.70–0.96).
The population attributable fraction for suboptimal cardiovascular health was 40.5% (95% CI = 2.7–74.0), with significant sex interaction (p for interaction = 0.032) and attenuation of associations after removing the nicotine exposure metric.

Study Design

Type

Cohort (n=60,556)

Structured PICO

Does high cardiovascular health (Life's Essential 8 score) reduce incident pancreatic cancer in cancer-free adults?

P

Population

60,556 cancer-free adults aged 20-74 years from Shanghai, China, followed for a median of 7.4 years.

E

Exposure

High cardiovascular health (Life's Essential 8 score ≥ 80)

C

Comparator

Low cardiovascular health (Life's Essential 8 score < 50)

O

Outcome

Incident pancreatic cancer at median 7.44 years follow-uphard clinical

Main Result

Hazard Ratio: 0.39 (95% CI 0.19–0.82)

Absolute Event Rate: 0.12% vs 0.64%

p-value: p=0.012

Higher cardiovascular health, as measured by the Life's Essential 8 score, is associated with a significantly lower risk of developing pancreatic cancer.

Limitations

Behavior components of the LE8 were self-reported and assessed only at baseline
FFQ did not distinguish low-fat or skim dairy products
Residual confounding cannot be completely excluded
Genetic susceptibility was not incorporated
Participants were recruited from suburban Shanghai, limiting generalizability
Potential selection bias from excluding individuals with incomplete data
Under-ascertainment of incident PC cases for participants who relocated outside Shanghai

Implication

Supports promoting cardiovascular health for potential pancreatic cancer prevention; extends Life's Essential 8 evidence but leaves causal effects open.

Abstract

Life's Essential 8 (LE8) is a comprehensive metric of cardiovascular health (CVH). Higher LE8 scores have been associated with lower risks of chronic diseases, but evidence regarding pancreatic cancer (PC) in Chinese populations is scarce. We analyzed data from 60,556 cancer-free adults in the Shanghai Suburban Adult Cohort and Biobank. LE8 includes four health behaviors (diet, physical activity, nicotine exposure, sleep) and four health factors (BMI, blood lipids, blood glucose, blood pressure), measured by questionnaires, physical examinations, and biochemical tests. Total scores (0-100) were categorized as low (< 50), moderate (50-79), and high (≥ 80) CVH. Incident PC was identified through cancer registries, hospital systems, and death records. Associations were assessed using multivariable Cox models. Over a median 7.4-year follow-up, 200 participants (0.3%) developed PC. Compared with participants with low CVH, those with moderate CVH (hazard ratio [HR] = 0.65, 95% confidence interval [CI] = 0.46-0.92) and high CVH (HR = 0.39, 95% CI = 0.19-0.82) had lower risks of PC. Each one standard deviation increase in LE8 score was associated with an 18% lower risk of PC (HR = 0.82, 95% CI = 0.70-0.96), with a linear inverse relationship. The association was attenuated after excluding the nicotine exposure component. The estimated population attributable fraction for suboptimal CVH was 40.5%. Stronger associations appeared in men and participants aged ≥ 60; a significant interaction with sex was observed. Overall, better LE8-defined CVH was associated with reduced PC risk, and smoking-related exposure may have contributed importantly to the observed association.

Discussion

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Cite This Study

Yi et al. (2026) conducted a cohort in Cancer-free adults (n=60,556). High Life's Essential 8 (LE8) score (≥ 80) vs. Low LE8 score (< 50) was evaluated on Incident pancreatic cancer (HR 0.39, 95% CI 0.19-0.82, p=0.012). High cardiovascular health, defined by a Life's Essential 8 score ≥ 80, was associated with a 61% lower risk of incident pancreatic cancer compared to low cardiovascular health (HR 0.39, 95% CI 0.19-0.82).

synapsesocial.com/papers/6a8fe99e10c91c1e92621549 https://doi.org/10.1111/cas.70512

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Association of Life's Essential 8 Score With Incident Pancreatic Cancer: A Prospective Cohort Study in Shanghai, China

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Association of Life's Essential 8 Score With Incident Pancreatic Cancer: A Prospective Cohort Study in Shanghai, China

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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