There is still a great deal that we do not understand about the cause and effect of risk factors and the development of pancreatic cancer.
It is important to remember that pancreatic cancer may also be due to a unique combination of environmental and inherited factors. Currently, the role of pancreatic screening for moderate-risk patients, such as patients with diabetes mellitus, obesity, or smokers, is less clear and warrants further studies to justify screening for these patients.
- Cigarette smoking is an important risk factor for the development of pancreatic cancer. Between 20-30% of pancreatic cancer cases are thought to be attributable to smoking. Smokers seem to have a dose-dependent risk but if someone has quit smoking for at least 10 years, the rate of pancreatic cancer may recede to that of individuals who have never smoked. In patients with a family history of pancreatic cancer, smoking increases the risk of developing pancreatic cancer and may cause the pancreatic cancer to develop earlier. Secondhand smoke is not thought to be associated with a higher risk.
- Diabetes mellitus (type II) has been shown to be associated with a two-fold higher risk for pancreatic cancer. However, the causality between diabetes and pancreatic cancer is still controversial. There is evidence on both sides for one causing the other: diabetes mellitus predisposes a patient to pancreatic cancer; and pancreatic cancer itself has been associated with glucose intolerance and diabetes. Screening for pancreatic cancer may be considered in a patient newly diagnosed with diabetes who is thin, has no other risk factors for diabetes, and has a family history of pancreatic cancer.
- Chronic pancreatitis is associated with a higher risk of developing pancreatic cancer.
- Obesity may be associated with a near two-fold higher risk of developing pancreatic cancer.
- Diet and its relationship to the development of pancreatic cancer has been conflicted. Certain published medical articles have linked diets rich in fat, with a high level of meat, and/or with processed meat and high soda beverage consumption to a higher rate of pancreatic cancer. Moderate intake of alcohol appears relatively safe, but in recent studies the excessive and prolonged drinking of alcohol has been linked to an increased likelihood of pancreatic cancer.
Continued research efforts are needed to identify patients with nonhereditary risk factors who would benefit from screening for pancreatic cancer.
For individuals from families at high risk of pancreatic cancer, interested patients may wish to participate in family cancer registries or ongoing research studies aimed at identifying genetic factors and new screening methods. Please visit the Muzzi Mirza Pancreatic Cancer Prevention and Genetics Program to learn more about the clinical trials and research studies.