Pancreatic Cancer Risk Factors: What You Should Be Aware Of

Your risk of developing pancreatic cancer is affected by many different factors. These factors include age, family history, lifestyle habits and health conditions. Being aware of the risk factors for pancreatic cancer can be an important step toward early detection. However, it is important to remember that risk factors do not guarantee you will or won’t develop pancreatic cancer. Some people who have one or more pancreatic cancer risk factors do not end up developing the disease, while others who have no risk factors can still end up with pancreatic cancer.

There are two types of risk factors:

• Non-modifiable risk factors

Unfortunately, there are factors beyond our control that increase the risk of pancreatic cancer. In such cases, alternate methods, such as regular imaging tests for surveillance, may be explored to overcome these risks.

• Modifiable risk factors

Studies have shown that our choices and environment can influence certain factors associated with pancreatic cancer risk. While it is not possible to completely eliminate the risk, making certain changes can still help reduce it to some extent.

The following are the main risk factors associated with pancreatic cancer that we cannot change.

Age

While pancreatic cancer can develop at any age, the risk increases with age. This means that it is more common for older people to be diagnosed with the disease. Almost all pancreatic cancer patients are above the age of 45 years and most of them are between the ages of 60 and 80 years.

As the body ages, it accumulates DNA errors and the effects of environmental exposures, which can increase the risk of genetic mutations. As the main cause of cancer lies in genetic mutations in the body’s cells, this can lead to a higher probability of developing any type of cancer, including pancreatic cancer.

Family history and genetic factors

Pancreatic cancer could develop due to gene changes that were passed on from parent to child. However, less than 10% of pancreatic cancer cases are due to known genetic factors. In fact, most people who develop pancreatic cancer do not have family history. Still, family history and genetic factors can play a role in pancreatic cancer risk.

Some of the genetic mutations which increase pancreatic cancer risk include:

• CDKN2A mutation (FAMMM syndrome)
• SPINK-1 mutation
• STK11 mutation (Peutz-Jeghers syndrome)
• BRCA1 and/or BRCA2 mutations (HBOC syndrome)
• MLH1 and/or MSH2 mutations (Lynch syndrome)
• APC mutation
• CTFR mutation
• PALB2 mutation
• ATM mutation
• PRSS1 mutation (hereditary pancreatitis)

Sex

Pancreatic cancer tends to be slightly more common in men than in women worldwide. The actual reasons for this are not entirely known, but the higher exposure to modifiable risk factors in men could partly contribute to this phenomenon.

The following are the main factors associated with a higher risk of pancreatic cancer that may still be modified through behavior or lifestyle changes.

Smoking

Smoking is the most important modifiable risk factor among the factors associated with pancreatic cancer. Those who smoke are about twice as likely to develop pancreatic cancer as compared to those who have never smoked. Smoking is thought to be responsible for about 25% of pancreatic cancer cases. The use of cigars, pipes and smokeless tobacco products, such as chewing tobacco, all increase pancreatic cancer risk.

Being overweight or obese

Being overweight or obese, or having a body mass index (BMI) greater than 25, increases the risk of pancreatic cancer, especially in women. People with a higher BMI are about 20% more likely to develop pancreatic cancer. There is also evidence that shows that fat distribution can affect pancreatic cancer risk. Waist-to-hip ratio or waist circumference is sometimes taken into consideration, together with BMI, to assess pancreatic cancer risk.

Diabetes

People with diabetes, especially type 2 diabetes, have a higher risk of developing pancreatic cancer. Diabetes occurs when the pancreas is unable to produce enough insulin or effectively use the insulin it produces. People who have had diabetes for longer also tend to have an increased risk of pancreatic cancer compared to those who have had diabetes for a shorter period of time.

In some cases, pancreatic cancer patients without diabetes can end up developing diabetes due to the cancer, known as new-onset diabetes mellitus. This could be due to surgery to remove the pancreas, which can result in diabetes, as there aren’t enough healthy pancreatic cells to produce insulin. However, some patients can also develop new-onset diabetes without surgical resection of the pancreas.

Chronic pancreatitis

Chronic or long-term inflammation of the pancreas, in conditions such as chronic pancreatitis, can increase the risk of pancreatic cancer. Sustained inflammation of the pancreas can cause genetic damage and uncontrolled cell growth, thereby increasing the chances of developing pancreatic cancer. Chronic pancreatitis is often linked to smoking and heavy alcohol use over a long period of time.

In some cases, pancreatitis can be caused by an inherited faulty gene. This is known as hereditary pancreatitis. However, only about 1% of all pancreatic cancer cases are caused by hereditary pancreatitis. While it is rare, people with hereditary pancreatitis do have a higher risk of developing pancreatic cancer compared to those who don’t.

Exposure to certain chemicals and metals

People who are exposed to certain chemicals have a higher risk of developing pancreatic cancer. Several studies have shown links between pancreatic cancer and exposure to chemicals and metals, such as pesticides, asbestos, benzene, chlorinated hydrocarbons, chromium and nickel.

Some studies have associated other factors with increased pancreatic cancer risk, but have produced inconclusive or inconsistent results. More research needs to be done to determine if these factors are indeed risk factors for pancreatic cancer.

Diet

Excessive consumption of red meat, processed meat and sugary drinks may increase pancreatic cancer risk.

Physical inactivity

Some research has shown links between physical inactivity and increased pancreatic cancer risk. While not all research proves this, regular physical activity and exercise may help in maintaining a healthy weight, which may in turn reduce pancreatic cancer risk.

Alcohol

Some studies suggest that the heavy and long-term consumption of alcohol could be linked to increased pancreatic cancer risk. However, it is still inconclusive if this risk is dose-dependent and if it is affected by the type of alcohol consumed.

Infections

Some studies show that certain bacterial or viral infections could increase pancreatic cancer risk. For example, Helicobacter pylori (H. pylori), a type of ulcer-causing bacteria that infects the stomach, is an established carcinogen and is suggested to increase pancreatic cancer risk.

While it is helpful to understand the risk factors for pancreatic cancer, it is important not to overanalyze them without consulting a medical professional. Having a high risk does not necessarily mean an individual will develop pancreatic cancer. If you have concerns, it is advisable to speak with a doctor who can provide an accurate evaluation and guide you on the next appropriate steps to take.