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| ==Overview== | | ==Overview== |
| Pancreatic cancer is associated with number of predisposing risk factors such as age, gender, ethnicity, and environmental exposures.
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| ==Risk Factors== | | ==Risk Factors== |
| Risk factors for pancreatic cancer include:<ref>http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_pancreatic_cancer_34.asp?sitearea=</ref>
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| *Age
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| *Male gender
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| *African ethnicity
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| *[[Tobacco smoking|Smoking]]
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| *Diets high in meat
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| *[[Obesity]]
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| *[[Diabetes]]
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| *[[Chronic pancreatitis]] has been linked, but is not known to be causal.
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| *Occupational exposure to certain [[pesticide]]s, [[dye]]s, and chemicals related to gasoline
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| *Family history, including [[autosomal recessive]] [[ataxia-telangiectasia]] and autosomal dominantly inherited mutations in the [[BRCA2]] [[gene]], [[Peutz-Jeghers syndrome]] due to mutations in the STK11 tumor suppressor gene, [[hereditary non-polyposis colon cancer]] (Lynch syndrome), familial adenomatous polyposis, and the familial atypical multiple mole melanoma-pancreatic cancer syndrome (FAMMM-PC) due to mutations in the ''[[CDKN2A]]'' tumor suppressor gene.<ref>{{cite journal |author=Efthimiou E, Crnogorac-Jurcevic T, Lemoine NR, Brentnall TA |year=2001 |month=Feb |title=Inherited predisposition to pancreatic cancer |journal=Gut |volume=48 |issue=2 |pages=143-7 |id=PMID 11156628 |url=}}</ref>
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| *''[[Helicobacter pylori]]'' infection
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| *Gingivitis or periodontal disease<ref>{{cite journal |author=Michaud DS, Joshipura K, Giovannucci E, Fuchs CS |title=A prospective study of periodontal disease and pancreatic cancer in US male health professionals |journal=J. Natl. Cancer Inst. |volume=99 |issue=2 |pages=171-5 |year=2007 |pmid=17228001 |doi=10.1093/jnci/djk021}}</ref>
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| ===Alcohol===
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| 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.<ref name=cruk>[[Cancer Research UK]] [http://www.cancerhelp.org.uk/help/default.asp?page=3102#alcohol Pancreatic cancer risks and causes]</ref> Overall, the association is consistently weak and the majority of studies have found no association.<ref name=aa21>[[National Institute on Alcohol Abuse and Alcoholism]] [http://pubs.niaaa.nih.gov/publications/aa21.htm Alcohol and Cancer - Alcohol Alert No. 21-1993]</ref><ref>[[American Cancer Society]] [http://www.cancer.org/docroot/NWS/content/update/NWS_1_1xU_Coffee_and_Alcohol_Do_Not_Pose_a_Risk_for_Pancreatic_Cancer.asp Coffee and Alcohol Do Not Pose a Risk for Pancreatic Cancer]</ref><ref>Villeneuve PJ, Johnson KC, Hanley AJ, Mao Y [http://www.ncbi.nlm.nih.gov/pubmed/10777010 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</ref><ref name=Michaud/>
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| Some studies suggest a relationship,<ref>Ahlgren, J. D., ''et al''. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8623060&dopt=Abstract Epidemiology and risk factors in pancreatic cancer] ''Seminars in Oncology'', 1996, ''23(2)'', 241-250.</ref> with risk increasing with increasing amount of alcohol intake.<ref>Cuzick J, Babiker AG [http://www.ncbi.nlm.nih.gov/pubmed/2925272 Pancreatic cancer, alcohol, diabetes mellitus and gall-bladder disease] ''Int J Cancer'' 1989 Mar 15;43(3):415-21</ref><ref>Harnack LJ, Anderson KE, Zheng W, Folsom AR, Sellers TA, Kushi LH [http://www.ncbi.nlm.nih.gov/pubmed/9419407 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</ref> Risk is greatest in heavy drinkers<ref>Schottenfeld, D. and J. Fraumeni, ed. Cancer epidemiology and prevention. 2nd ed., ed. Vol. 1996, Oxford University Press: Oxford</ref><ref name=Ye>W Ye, J Lagergren, E Weiderpass, O Nyrén, H-O Adami, A Ekbom [http://gut.bmj.com/cgi/content/abstract/51/2/236 Alcohol abuse and the risk of pancreatic cancer] ''Gut'' 2002;51:236-239</ref><ref name=Silverman>Silverman DT, Brown LM, Hoover RN, Schiffman M, Lillemoe KD, Schoenberg JB, Swanson GM, Hayes RB, Greenberg RS, Benichou J, et al [http://www.ncbi.nlm.nih.gov/pubmed/7585527?dopt=Abstract Alcohol and pancreatic cancer in blacks and whites in the United States] ''Cancer Res'', 1995. 55(21): p. 4899-905. PMID: 7585527</ref> mostly on the order of four or more drinks per day.<ref>G W Olsen, J S Mandel, R W Gibson, L W Wattenberg and L M Schuman [http://www.ajph.org/cgi/reprint/79/8/1016 A case-control study of pancreatic cancer and cigarettes, alcohol, coffee and diet] ''American Journal of Public Health'' Vol. 79, Issue 8 1016–1019</ref> There appears to be no increased risk for people consuming up to 30g of alcohol a day,<ref name=Michaud>Michaud DS, Giovannucci E, Willett WC, Colditz GA, Fuchs CS [http://www.ncbi.nlm.nih.gov/pubmed/11352851 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</ref><ref>[http://info.cancerresearchuk.org/cancerstats/types/pancreas/riskfactors/ Pancreatic cancer risk factors]</ref> so most of the U.S. consumes alcohol at a level that "is probably not a risk factor for pancreatic cancer."<ref name=Silverman/>
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| Several studies caution that their findings could be due to confounding factors.<ref name=Ye/><ref>Zatonski WA, Boyle P, Przewozniak K, Maisonneuve P, Drosik K, Walker AM [http://www.ncbi.nlm.nih.gov/pubmed/8436433 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</ref> Even if a link exists, it "could be due to the contents of some alcoholic beverages"<ref>Durbec JP, Chevillotte G, Bidart JM, Berthezene P, Sarles H. [http://www.ncbi.nlm.nih.gov/pubmed/6849792 Diet, alcohol, tobacco and risk of cancer of the pancreas: a case-control study] ''Br J Cancer'' 1983 Apr;47(4):463-70.</ref> other than the alcohol itself. One Dutch study even found that drinkers of white wine had lower risk.<ref>Bueno de Mesquita HB, Maisonneuve P, Moerman CJ, Runia S, Boyle P. [http://www.ncbi.nlm.nih.gov/pubmed/1537615 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</ref>
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]
Overview
Risk Factors
- Risk factors for Pancreatic Cancers:[1]
| Risk factors for Pancreatic Cancer
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| Risk factors
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- Family history of pancreatic cancer
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| Familial Cancer Syndromes
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- Familial adenomatous polyposis (FAP)
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- Familial atypical multiple mole melanoma syndrome (FAMMM)
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- von Hippel-Lindau syndrome
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- Multiple endocrine neoplasia type 1
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| Other medical conditions
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- Inflammatory bowel disease
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- Risk Factors and Inherited Syndromes associated with Pancreatic Cancer:[2]
| Risk Factors and Inherited Syndromes associated with Pancreatic Cancer
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| Risk Factor
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Approximate Risk
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| Smoking
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2-3 %
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| Long-standing Diabetes mellitus
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2 %
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| Nonhereditery and Chronic Pancreatitis
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2-6 %
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| Obesity, Inactivity or both
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2 %
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| Non O Blood Group
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1-2 %
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| Genetic Syndrome and Associated Gene or Genes
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| Hereditary pancreatitis (PRSS1, SPINK1)
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50 %
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| Familial atypical multiple mole and melanoma syndrome (p16)
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10-20 %
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| Hereditary breast and ovarian cancer syndromes (BRCA1, BRCA2, PALB2)
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1-2 %
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| Peutz-Jeghers syndrome (STK11 [LKB1])
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30-40 %
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| Hereditary nonpolyposis colon cancer (Lynch syndrome) (MLH1, MSH2, MSH6)
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4 %
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| Ataxia-telangiectasia (ATM)
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Unknown
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| Li-Fraumeni syndrome (P53)
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Unknown
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References
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