Risk+Factors


 * Risk Factors & Prevention of Pancreatic Cancer **
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toc Researchers have found several factors that affect a person's chance of getting cancer of the pancreas. Most of these are risk factors for exocrine pancreatic cancer.

** Age **
The risk of developing pancreatic cancer increases with age. Almost all patients are older than 45 years. Nearly 90% are older than 55 years and more than 70% are older than 65. The average age at the time of diagnosis is 72.

** Gender **
Men are slightly more likely to develop pancreatic cancer than are women. This may be due, at least in part, to increased tobacco use in men. The difference in pancreatic cancer risk was more pronounced in the past (when tobacco use was much more common among men than women), but the gap has closed in recent years.

** Race **
African Americans are more likely to develop pancreatic cancer than whites. The reasons for this are not clear, but it may be due in part to higher rates of smoking and diabetes in men and being overweight in women.

** Cigarette smoking **
The risk of getting pancreatic cancer is 2 to 3 times higher among smokers. Scientists think this may be due to cancer-causing chemicals in cigarette smoke that enter the blood and damage the pancreas. About 20% to 30% of exocrine pancreatic cancer cases are thought to be caused by cigarette smoking. Current research reveals a strong correlation between tobacco use and pancreatic cancer. People who use smokeless tobacco are also more likely to get exocrine pancreatic cancer.

** Obesity and physical activity **
Very overweight (obese) people are more likely to develop exocrine pancreatic cancer, as are people who don't get much physical activity. Exercise lowers the risk of this cancer.

** Diabetes **
Exocrine pancreatic cancer is more common in people with this disease. The reason for this link is not known. Most of the risk is found in people with type 2 diabetes. This type of diabetes most often starts in adulthood. It is often related to being overweight or obese. It is not clear if people with type 1 diabetes have a higher than average risk. In some patients, though, the cancer seems to have caused the diabetes (not the other way around).

** Chronic pancreatitis **
Chronic pancreatitis is a long-term inflammation of the pancreas. This condition is linked with an increased risk of pancreatic cancer, but most patients with pancreatitis never develop pancreatic cancer. The link between chronic pancreatitis and pancreatic cancer is strongest in smokers. A small number of cases of chronic pancreatitis appear to be due to an inherited gene mutation. People with this inherited form of chronic pancreatitis seem to have a high lifetime risk for developing pancreatic cancer (about 40% to 75%).

** Cirrhosis of the liver **
Cirrhosis is a scarring of the liver. It occurs in people with liver damage from things like hepatitis and alcohol use. People with cirrhosis seem to have an increased risk of pancreatic cancer.

** Occupational exposure **
Heavy exposure at work to certain pesticides, dyes, and chemicals used in metal refining may increase the risk of developing pancreatic cancer.

** Family history **
Pancreatic cancer seems to run in some families. In some of these families, the high risk is due to an inherited syndrome. In other families, the gene causing the increased risk of pancreatic cancer is not known.

** Genetic syndromes **
Inherited gene mutations are abnormal copies of certain genes that can be passed from parent to child. These abnormal genes may cause as many as 10% of pancreatic cancers and can cause other problems as well. Examples of the genetic syndromes that can cause exocrine pancreatic cancer include: Pancreatic neuroendocrine tumors and cancers can also be caused by a genetic syndrome, such as:
 * Hereditary breast and ovarian cancer syndrome **, caused by mutations in the gene //BRCA2//
 * Familial melanoma **, caused by mutations in the gene //p16//
 * Familial pancreatitis **, caused by mutations in the gene //PRSS1//
 * Hereditary non-polyposis colorectal cancer ** (HNPCC), most often caused by a defect in either the gene //MLH1// or the gene //MSH2//. At least 5 other genes can also cause HNPCC: //MLH3, MSH6, TGBR2, PMS1//, and //PMS2.// This disorder is also known as Lynch syndrome.
 * Peutz-Jeghers syndrome ** (PJS), caused by defects in the gene //STK1//. This syndrome is also linked with polyps in the digestive tract and several other cancers
 * Von Hippel-Lindau syndrome **, caused by mutations in the gene //VHL//, can lead to an increased risk of pancreatic cancer and carcinoma of the ampulla of Vater
 * Neurofibromatosis, type 1 **, which is caused by mutations in the gene //NF1//. This syndrome leads to an increased risk of many tumors, including somatostatinomas.
 * Multiple endocrine neoplasia, type 1 **, caused by mutations in the gene //MEN1//, leads to an increased risk of tumors of the parathyroid gland, the pituitary gland, and the islet cells of the pancreas.

** Stomach problems **
Infection of the stomach with the ulcer-causing bacteria //Helicobacter pylori// (//H. pylori//) may increase the risk of getting pancreatic cancer. Some researchers believe that excess stomach acid may also increase the risk.

** Diet **
Some studies have found a link between pancreatic cancer and diets high in fat, or those that include a lot of red meat, pork, and processed meat (such as sausage and bacon). Others have found that diets high in fruits and vegetables may help reduce the risk of pancreatic cancer. But not all studies have found such links, and the exact role of diet in relation to pancreatic cancer is still under study.

** Coffee **
Some older studies have suggested that drinking coffee might increase the risk of pancreatic cancer, but more recent studies have not confirmed this.

** Alcohol **
Most studies have not found a link between alcohol use and pancreatic cancer. But heavy alcohol use can raise the risk of diabetes, liver cirrhosis, and chronic pancreatitis, which are risk factors for pancreatic cancer.


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=Summary=

Although the exact cause of pancreatic cancer is unknown, associations with cigarette smoking (incidence is more than twice as high for smokers as nonsmokers); diets high in fat, meat, dehydrated foods, fried foods, refined sugars, soybeans, and nitrosamines; diabetes mellitus and chronic pancreatitis have been suggested. Persons who have occupational exposure to gasoline derivatives, naphthylamine, and benzidine are considered to be at higher risk. High coffee consumption and alcohol intake have been implicated; however, many believe a direct effect of these substances on the development of pancreatic cancer is questionable. There are no established guidelines for preventing pancreatic cancer. For now, the best approach is to avoid pancreatic cancer risk factors whenever possible. Cigarette smoking is the most important avoidable risk factor for pancreatic cancer. It is responsible for 20% to 30% of pancreatic cancers. Tobacco use also increases the risk of many other cancers such as cancers of the lung, mouth, larynx (voice box), esophagus, kidney, bladder, and some other organs. Maintaining a healthy weight, eating well, and exercising are also important. The American Cancer Society recommends choosing foods and beverages in amounts that help achieve and maintain a healthy weight. Eat at least 5 servings of fruits and vegetables every day, as well as servings of whole grain foods from plant sources such as rice, breads, pasta, and cereals. Eat less processed and red meat. Following these recommendations may lower your risk of getting pancreatic cancer, as well as several other cancers and some non-cancerous diseases.