{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:19:02Z","timestamp":1787663942434,"version":"build-2736575974"},"reference-count":83,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004484","name":"Tehran University of Medical Sciences and Health Services","doi-asserted-by":"publisher","award":["1401\u20104\u2010212\u201064491"],"award-info":[{"award-number":["1401\u20104\u2010212\u201064491"]}],"id":[{"id":"10.13039\/501100004484","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite previous meta\u2010analysis studies on the association between adherence to the Mediterranean diet and risk of pancreatic cancer, there has not been a comprehensive and updated study reviewing all studies with inclusion criteria. Despite advances in cancer treatment and control, pancreatic cancer is still one of the deadliest malignancies, and the mortality rate is consistent with its prevalence. Therefore, this updated systematic review and dose\u2013response meta\u2010analysis study was conducted to examine the association between one of the healthiest dietary patterns, the Mediterranean dietary pattern, and the rate of pancreatic cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using relevant keywords, electronic searches for prospective cohort studies were conducted in Web of Science, PubMed, and Scopus until March 17, 2025. The reported hazard ratios (HRs) in the primary studies were regarded as the main effect size. The overall effect was calculated using a random\u2010effects model that accounts for between\u2010study variability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Based on 10 prospective studies, we found that people who adhered more strictly to the Mediterranean diet had a lower risk of developing pancreatic cancer (pooled HR: 0.90; CI: 0.82\u20130.98;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200946.72%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value\u2009=\u20090.05). Also, outcome types had different effects in subgroup analyses. In the incidence and mortality of pancreatic cancer, there was a significant reduction, but this reduction was not significant in the risk of pancreatic cancer. Our dose\u2013response analysis showed no evidence of a linear association; however, it indicated that following a Mediterranean dietary pattern may have a non\u2010linear effect on the risk of pancreatic cancer, reducing it (\n                      <jats:italic>P<\/jats:italic>\n                      \u2010nonlinearity\u2009=\u20090.04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The present systematic review and dose\u2013response meta\u2010analysis of prospective cohort studies provides compelling evidence for an inverse relationship between adherence to the Mediterranean diet and the risk of pancreatic cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registry and Registry Number for Systematic Reviews or Meta\u2010Analyses<\/jats:title>\n                    <jats:p>\n                      The study's protocol was registered in the international prospective registry of systematic reviews (URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?RecordID=423150\">https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?RecordID=423150<\/jats:ext-link>\n                      and Registration ID: CRD42023423150).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72176","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:16:49Z","timestamp":1787030209000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mediterranean Diet and Risk of Pancreatic Cancer\u2014Is It Worth Investigating More? An Updated Systematic Review and Dose\u2013Response Meta\u2010Analysis of Prospective Cohort Studies"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4924-8261","authenticated-orcid":false,"given":"Moharam","family":"Jalalzadeh","sequence":"first","affiliation":[{"name":"Department of Community Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soraiya","family":"Ebrahimpour\u2010Koujan","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences  Tehran Iran"},{"name":"Autoimmune Bullous Disease Research Center, Razi Hospital Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motahareh","family":"Yadegari","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Faculty of Medicine Mashhad University of Medical Sciences  Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maedeh","family":"Moradi","sequence":"additional","affiliation":[{"name":"Adelaide Medical School, University of Adelaide  Adelaide South Australia Australia"},{"name":"Lifelong Health Theme South Australian Health and Medical Research Institute (SAHMRI)  Adelaide South Australia Australia"},{"name":"Robinson Research Institute University of Adelaide  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsen","family":"Montazer","sequence":"additional","affiliation":[{"name":"Department of Community Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7169-6960","authenticated-orcid":false,"given":"Leila","family":"Azadbakht","sequence":"additional","affiliation":[{"name":"Department of Community Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences  Tehran Iran"},{"name":"Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute Tehran University of Medical Sciences  Tehran Iran"},{"name":"Department of Community Nutrition, School of Nutrition and Food Science Isfahan University of Medical Sciences  Isfahan 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