Pancreatic cancer risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Pancreatic cancer is associated with number of predisposing risk factors such as age, gender, ethnicity, and environmental exposures.

Risk Factors

Risk factors for pancreatic cancer include:[1]

Alcohol

It is controversial whether alcohol consumption is a risk factor for pancreatic cancer. Drinking alcohol excessively is a major cause of chronic pancreatitis, which in turn predisposes to pancreatic cancer, but chronic pancreatitis that is due to alcohol doesn't increase risk as much as other types of chronic pancreatitis.[4] Overall, the association is consistently weak and the majority of studies have found no association.[5][6][7][8]

Some studies suggest a relationship,[9] with risk increasing with increasing amount of alcohol intake.[10][11] Risk is greatest in heavy drinkers[12][13][14] mostly on the order of four or more drinks per day.[15] There appears to be no increased risk for people consuming up to 30g of alcohol a day,[8][16] so most of the U.S. consumes alcohol at a level that "is probably not a risk factor for pancreatic cancer."[14]

Several studies caution that their findings could be due to confounding factors.[13][17] Even if a link exists, it "could be due to the contents of some alcoholic beverages"[18] other than the alcohol itself. One Dutch study even found that drinkers of white wine had lower risk.[19]



  • Risk factors for Pancreatic Cancers:[20]
Risk factors for Pancreatic Cancer
Risk factors
  • Smoking
  • Alcohol
  • Increased BMI
  • Diabetes mellitus
  • Chronic pancreatitis
  • Family history of pancreatic cancer
Familial Cancer Syndromes
  • BRCA1, BRCA2
  • Familial adenomatous polyposis (FAP)
  • Peutz-Jeghers syndrome
  • Familial atypical multiple mole melanoma syndrome (FAMMM)
  • Lynch syndrome
  • von Hippel-Lindau syndrome
  • Multiple endocrine neoplasia type 1
  • Gardner syndrome
Other medical conditions
  • Inflammatory bowel disease
  • Periodontal disease
  • Peptic ulcer disease


  • Risk Factors and Inherited Syndromes associated with Pancreatic Cancer:[21]
Risk Factors and Inherited Syndromes associated with Pancreatic Cancer
Risk Factor Approximate Risk
Smoking 2-3 %
Long-standing Diabetes mellitus 2 %
Nonhereditery and Chronic Pancreatitis 2-6 %
Obesity, Inactivity or both 2 %
Non O Blood Group 1-2 %
Genetic SYndrome and Associated Gene or Genes
Hereditary pancreatitis (PRSS1, SPINK1) 50 %
Familial atypical multiple mole and melanoma syndrome (p16) 10-20 %
Hereditary breast and ovarian cancer syndromes (BRCA1, BRCA2, PALB2) 1-2 %
Peutz-Jeghers syndrome (STK11 [LKB1]) 30-40 %
Hereditary nonpolyposis colon cancer (Lynch syndrome) (MLH1, MSH2, MSH6) 4 %
Ataxia-telangiectasia (ATM) Unknown
Li-Fraumeni syndrome (P53) Unknown

References

  1. http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_pancreatic_cancer_34.asp?sitearea=
  2. Efthimiou E, Crnogorac-Jurcevic T, Lemoine NR, Brentnall TA (2001). "Inherited predisposition to pancreatic cancer". Gut. 48 (2): 143–7. PMID 11156628. Unknown parameter |month= ignored (help)
  3. Michaud DS, Joshipura K, Giovannucci E, Fuchs CS (2007). "A prospective study of periodontal disease and pancreatic cancer in US male health professionals". J. Natl. Cancer Inst. 99 (2): 171–5. doi:10.1093/jnci/djk021. PMID 17228001.
  4. Cancer Research UK Pancreatic cancer risks and causes
  5. National Institute on Alcohol Abuse and Alcoholism Alcohol and Cancer - Alcohol Alert No. 21-1993
  6. American Cancer Society Coffee and Alcohol Do Not Pose a Risk for Pancreatic Cancer
  7. Villeneuve PJ, Johnson KC, Hanley AJ, Mao Y Alcohol, tobacco and coffee consumption and the risk of pancreatic cancer: results from the Canadian Enhanced Surveillance System case-control project. Canadian Cancer Registries Epidemiology Research Group Eur J Cancer Prev 2000 Feb;9(1):49-58. PMID: 10777010
  8. 8.0 8.1 Michaud DS, Giovannucci E, Willett WC, Colditz GA, Fuchs CS Coffee and alcohol consumption and the risk of pancreatic cancer in two prospective United States cohorts Cancer Epidemiol Biomarkers Prev 2001 May;10(5):429-37 PMID: 11352851
  9. Ahlgren, J. D., et al. Epidemiology and risk factors in pancreatic cancer Seminars in Oncology, 1996, 23(2), 241-250.
  10. Cuzick J, Babiker AG Pancreatic cancer, alcohol, diabetes mellitus and gall-bladder disease Int J Cancer 1989 Mar 15;43(3):415-21
  11. Harnack LJ, Anderson KE, Zheng W, Folsom AR, Sellers TA, Kushi LH Smoking, alcohol, coffee, and tea intake and incidence of cancer of the exocrine pancreas: the Iowa Women's Health Study Cancer Epidemiol Biomarkers Prev 1997 Dec;6(12):1081-6 PMID: 9419407
  12. Schottenfeld, D. and J. Fraumeni, ed. Cancer epidemiology and prevention. 2nd ed., ed. Vol. 1996, Oxford University Press: Oxford
  13. 13.0 13.1 W Ye, J Lagergren, E Weiderpass, O Nyrén, H-O Adami, A Ekbom Alcohol abuse and the risk of pancreatic cancer Gut 2002;51:236-239
  14. 14.0 14.1 Silverman DT, Brown LM, Hoover RN, Schiffman M, Lillemoe KD, Schoenberg JB, Swanson GM, Hayes RB, Greenberg RS, Benichou J, et al Alcohol and pancreatic cancer in blacks and whites in the United States Cancer Res, 1995. 55(21): p. 4899-905. PMID: 7585527
  15. G W Olsen, J S Mandel, R W Gibson, L W Wattenberg and L M Schuman A case-control study of pancreatic cancer and cigarettes, alcohol, coffee and diet American Journal of Public Health Vol. 79, Issue 8 1016–1019
  16. Pancreatic cancer risk factors
  17. Zatonski WA, Boyle P, Przewozniak K, Maisonneuve P, Drosik K, Walker AM Cigarette smoking, alcohol, tea and coffee consumption and pancreas cancer risk: a case-control study from Opole, Poland Int J Cancer 1993 Feb 20;53(4):601-7 PMID: 8436433
  18. Durbec JP, Chevillotte G, Bidart JM, Berthezene P, Sarles H. Diet, alcohol, tobacco and risk of cancer of the pancreas: a case-control study Br J Cancer 1983 Apr;47(4):463-70.
  19. Bueno de Mesquita HB, Maisonneuve P, Moerman CJ, Runia S, Boyle P. Lifetime consumption of alcoholic beverages, tea and coffee and exocrine carcinoma of the pancreas: a population-based case-control study in The Netherlands Int J Cancer 1992 Feb 20;50(4):514-22 PMID: 1537615
  20. Bond-Smith G, Banga N, Hammond TM, Imber CJ (2012). "Pancreatic adenocarcinoma". BMJ. 344: e2476. doi:10.1136/bmj.e2476. PMID 22592847.
  21. Ryan DP, Hong TS, Bardeesy N (2014). "Pancreatic adenocarcinoma". N Engl J Med. 371 (11): 1039–49. doi:10.1056/NEJMra1404198. PMID 25207767.

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