Critical Appraisal (Paraphrasing)

Running head: CRITICAL APPRAISAL
Critical Appraisal (Paraphrasing)
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Critical Appraisal
Summary and Critical Appraisal of the Study
The primary focus of this paper is the determination of how diet plays a key role in
affecting the development of pancreatic cancer by the study (Jansen et al., 2014). The patients
in Mayo Clinic in United States of America have been undertaken for the case-control study.
The data for the study was collected for a period of five years from May of 2004 to December
of 2009 and were analysed to understand the relationship between diet of the participants and
pancreatic cancer. A critical appraisal for the study conducted by Jansen (2014) will be
presented in this paper which will help in determining the implications by providing a
summary of the study.
The study conducted by Jansen et al., (2014) examined the relationship between the
pancreatic cancer and the inclusion of specific fats in the diet. It was published in the year
2014 and titled, “Fatty acids found in dairy, protein and unsaturated fatty acids are associated
with risk of pancreatic cancer in a case-control study”. The focus of the study was the effect
of specific fatty acids rather than all fatty acids found in meat, fish and dairy products in the
development and risk of pancreatic cancer as researched by previous authors. In the study
conducted by the authors, it could be observed that individuals who had consumed a diet
higher in protein and unsaturated fatty acids, there was a decrease in the number of pancreatic
cancer cases. However, if an individual consumes fats which are prevalent in dairy, have
been observed to increase the risk of pancreatic cancer. The study had conducted the
methodology of case-control which was appropriate for this kind of study while also
addressing the research questions that were laid out in the study.
The participants of the study were selected on the basis of tem attending the Mayo
Clinic and were followed up for five years with no form of bias in their selection. Majority of
the cases that have been reported have been co-related with medical and pathology reports.

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Critical Appraisal
The controls have been selected on the basis of the patients who have received primary care
with high frequency match on the age of recruitment, sex, region of residence and race.
However, there was nothing special observed for the controls that have been selected
population-based. They were provided with a 144-item food frequency questionnaire which
helped the authors of the study to understand the diet of the participants (Jansen et al., 2014).
To help in the determination of Odd Ratios, statistical analysis and logic regression model at
confidence level of 95% were conducted on the data collected. The adjustment for the results
obtained contained additional parameters drug use, age, sex, savings of daily food and BMI
(Jansen et al., 2014). The variables that have been included have all been considered which
are associated with dietary intake and pancreatic cancer. However, only p-values lesser than
0.05 were given significance.
Appropriate software and important data have been used for the analysis of the study;
hence, the study could be stated believable and free from any form of bias. For the reduction
of bias, the exposure of the study was clearly defined and used objectives measurements in
the form of statistical software for the analysis of the data. In the study design, there was no
blinding observed for the participants that have undertaken the study. The confounding
variables that have been observed in the study to influence the results are the PUFA
groupings. The design of the study was well-structured; hence, making it more reliable. The
results presented by the authors in the study was well presented which made it easy for
understanding for the readers and identify the most significant values (Jansen et al., 2019).
Tables were constructed with labels of OR, Quintile values and the p-value for appropriate
presentation of the data.
One of the benefits of the study conducted is the implementation of measures for
decreasing the cases of pancreatic cancer as analysed by Norat, (2014). The first task is to
inform the medical community about the risk factors that can influence the development of

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Critical Appraisal
pancreatic cancer. It is after this that the doctor’s advice people regarding the topic and shares
knowledge on measures to be taken to avoid and eat for consumption (Hu, 2011).
It is because of this study that some markers which can help in the early detection of
pancreatic cancers could be identified. The history of consumption and diet helps in
appropriate diagnosis of the disease (Banim, 2013). It is in this way that there is a decrease in
the mortality rate of the disease in the population.
It can be observed that people in the local setting will be benefitted because of the
study being reliable. The reason of the results being valid is that they are consistent with
other evidences which are available. Previous researches had been conducted which
established a relationship between likelihood of pancreatic cancer and total fat content
(Giacosa, 2013). However, this study revolutionized the knowledge and conducted a research
to understand the influence of specific types of fatty acids which can increase the risk of
pancreatic cancer. Hence, it can be understood that this study has helped in understanding the
link which, in turn, can be conveyed to the population to reduce the harm caused by
pancreatic cancer.

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Critical Appraisal
Public Health Implications
It has been observed that pancreatic cancer is one of the most deadly form of cancer
that is prevalent in the world (Beaney et al., 2017). When compared to other form of cancers,
the highest mortality rate in observed in people diagnosed with pancreatic cancer (Giacosa,
2013; Taylor et al., 2015). This study helped in identifying the several implications which is
observed on public health. Many NGO’s and Governmental agencies have been increasing
the rates of cancer research after measuring the prevalence rate of pancreatic cancer (Norat,
2014). The study by Jansen et al., (2014), helped in outlining the implications on public
health of pancreatic cancer.
In usual times, the detection of pancreatic cancer is difficult and hence, its treatment.
However, the study helped in shedding light on some causes of the disease. The symptoms
that have been observed in pancreatic cancer patients are highly un-specific. Hence, it is
evident to be mistaken for some other disease. In addition, the detection of pancreatic tumour
is difficult as pancreas is shielded by other organs (Norat, 2014). There are not many imaging
techniques which could be used for the detection of the tumour. In addition to the imaging
techniques, scientists have also failed to identify gene mutations and biomarkers for the
appropriate diagnoses of the disease (Banim, 2013). Hence, it is because of this scientific
dysfunctionality that the detection of pancreatic cancer is done at a very later stage. In
addition, the mortality rates of pancreatic cancer is on the higher side because of this
anomaly. Moreover, it has also been observed about their resistance to certain types of
therapy which further decreases the chances of the individuals to get accurate treatment
(Banim, 2013)
The study conducted by Jansen et al., (2014), helped in identifying ways to diagnose
pancreatic cancer. The diet of the patient has been identified to play a key role in diagnosing

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Critical Appraisal
pancreatic cancer. However, the symptoms that are observed for pancreatic cancer overlap
with symptoms that are associated with other deadly diseases (Norat, 2014). However, it is in
the hands of the physician to use this symptoms in collaboration with the diet of the
individual to make an appropriate diagnosis for the detection of pancreatic cancer.
It was because of this study that it could be determined that risk of pancreatic cancer
is increased because of the consumption of saturated fatty acids which are found in yogurts. It
is because of this that Yoghurt was made a necessary part of the research study such that to
determine the connection. The results that have been obtained ascertain the assumption that
had been made. Hence, if these results are used by dieticians to individuals will help in
reducing the health burden of pancreatic cancer in the world (Giacosa, 2013) and mortality
rates.
Certain amount of health implications have been identified because of the public
health measures undertaken to control the cause of pancreatic cancer. In the previous studies,
smoking was one of the most definite risk factors associated with causing pancreatic cancer
(Giacosa, 2013). After the conduction of the study by Jansen et al., (2014), the scientists
considered diet as another risk factor which could play a significant role in the suffering of
people with pancreatic cancer. Hence, it is critical for public health measures to be directed
towards controlling diet of the individuals.
In concluding remarks, it can be clearly understood that pancreatic cancer is a high
mortality lethal disease. There are certain markers which are identified because of this study
which can help in increasing the rate of early diagnosis of pancreatic cancer. One of the risk
factors associated is diet which is high in saturated fats. Hence, measures by public health
organizations should be directed towards shifting the dietary choices of an individual to
reduce the prevalence of pancreatic cancer.

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Critical Appraisal
References
Banim, P. J., Luben, R., McTaggart, A., Welch, A., Wareham, N., Khaw, K. T., & Hart, A. R.
(2013). Dietary antioxidants and the etiology of pancreatic cancer: a cohort study
using data from food diaries and biomarkers. Gut, 62(10), 1489-1496.
Beaney, A. J., Banim, P. J., Luben, R., Lentjes, M. A., Khaw, K. T., & Hart, A. R. (2017).
Higher Meat Intakes Are Positively Associated With Higher Risks of Developing
Pancreatic Cancer in an Age-dependent Manner and Are Modified by Plasma Anti-
oxidants: A Prospective Cohort Study (EPIC-Norfolk) Using Data From Food
Diaries. Pancreas, 46(5), 672.
Giacosa, A., Barale, R., Bavaresco, L., Gatenby, P., Gerbi, V., Janssens, J., ... & Morazzoni,
P. (2013). Cancer prevention in Europe: the Mediterranean diet as a protective
choice. European Journal of Cancer Prevention, 22(1), 90-95.
Hu, J., La Vecchia, C., De Groh, M., Negri, E., Morrison, H., Mery, L., & Canadian Cancer
Registries Epidemiology Research Group. (2011). Dietary transfatty acids and cancer
risk. European Journal of Cancer Prevention, 20(6), 530-538.
Jansen, R. J., Robinson, D. P., Frank, R. D., Anderson, K. E., Bamlet, W. R., Oberg, A. L., ...
& Stolzenberg‐Solomon, R. Z. (2014). Fatty acids found in dairy, protein and
unsaturated fatty acids are associated with risk of pancreatic cancer in a case–
control study. International journal of cancer, 134(8), 1935-1946.
Norat, T., Aune, D., Chan, D., & Romaguera, D. (2014). Fruits and vegetables: updating the
epidemiologic evidence for the WCRF/AICR lifestyle recommendations for cancer
prevention. In Advances in nutrition and cancer (pp. 35-50). Springer, Berlin,
Heidelberg.

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Critical Appraisal
Taylor, J. W., Long, M., Ashley, E., Denning, A., Gout, B., Hansen, K., ... & Wojtowicz, A.
(2015). When medical news comes from press releases—A case study of pancreatic
cancer and processed meat. PloS one, 10(6).