Risk factors for pancreatic cancer
A risk factor is something that increases the risk of developing cancer. It could be a behaviour, substance or condition. Most cancers are the result of many risk factors. But sometimes pancreatic cancer develops in people who don’t have any of the risk factors described below.
Precancerous conditions of the pancreas include mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN). They aren’t cancer, but they can sometimes become pancreatic cancer if they aren’t treated. Some of the risk factors for pancreatic cancer may also cause these precancerous conditions. Find out more about precancerous conditions of the pancreas.
Risk factors are generally listed in order from most to least important. But in most cases, it is impossible to rank them with absolute certainty.
Research shows that there is no link between coffee and a higher risk for pancreatic cancer.
Known risk factors @(Model.HeadingTag)>
There is convincing evidence that the following factors increase your risk for pancreatic cancer.
About 20%–30% of pancreatic cancers are related to smoking tobacco. The risk increases with the number of cigarettes and the number of years you smoke. The risk goes down as soon as you quit smoking. The longer you go without smoking after you quit, the lower the risk of developing pancreatic cancer. Smoking cigars and pipes and using smokeless tobacco products, such as chewing tobacco and snuff, also increase your risk of pancreatic cancer.
People who have obesity or a high
Pancreatic cancer is more common in people with diabetes, but the reason for this connection is not fully understood. It may be that obesity is a risk for both diabetes and pancreatic cancer, or diabetes may be an early sign of pancreatic cancer.
Family history of pancreatic cancer @(Model.HeadingTag)>
About 10%–20% of pancreatic cancers are hereditary or familial, which means they run in a family. Familial pancreatic cancer means that at least 2 first-degree relatives (father, mother, brother, sister or child) or any 3 family members have been diagnosed with pancreatic cancer. The risk for pancreatic cancer increases with the number of family members who have the disease. In some families, the increased risk may be due to an inherited genetic condition. In other families, doctors don’t know the reason for the increased occurrence.
Certain genetic conditions @(Model.HeadingTag)>
The following genetic conditions are linked with a higher risk of pancreatic cancer.
Hereditary breast and ovarian cancer (HBOC) syndrome is an inherited condition caused by changes (mutations) to the BRCA1 or BRCA2 gene. People with HBOC syndrome have an increased risk of breast, ovarian, prostate, pancreatic and fallopian tube cancer.
Familial atypical multiple mole melanoma (FAMMM) syndrome is an inherited condition that usually affects several members of a family. Family members with FAMMM develop melanoma skin cancer and a large number of atypical moles. The moles are usually different sizes and shades. FAMMM is caused by a mutation of p16 gene.
Peutz-Jeghers syndrome is an inherited syndrome that causes a very large number of polyps to develop in the gastrointestinal tract. It also causes dark spots on the lips and around and inside the mouth.
Lynch syndrome (also called hereditary non-polyposis colorectal cancer, or HNPCC) is a rare inherited syndrome that may lead to colorectal cancer. People with type B Lynch syndrome have a higher risk of developing certain cancers, including pancreatic cancer.
Hereditary pancreatitis is a rare genetic condition that causes severe pancreatitis at a young age, often before a child is 10 years old. Pancreatitis is inflammation of the pancreas.
Multiple endocrine neoplasia type 1 (MEN1) and von Hippel-Lindau syndrome are genetic conditions. They may increase your risk of developing pancreatic neuroendocrine cancer (islet cell cancer). Find out more about pancreatic neuroendocrine tumours (pNETs).
Chronic pancreatitis @(Model.HeadingTag)>
Chronic pancreatitis is long-term inflammation of the pancreas. People with this condition have a higher risk for pancreatic cancer. Some studies also show a link between acute pancreatitis and pancreatic cancer. Acute pancreatitis is sudden, short-term inflammation of the pancreas.
Eating red meat @(Model.HeadingTag)>
Studies have shown that eating red meat increases the risk of pancreatic cancer.
Possible risk factors @(Model.HeadingTag)>
The following factors have been linked with pancreatic cancer, but there is not enough evidence to show they are known risk factors. More research is needed to clarify the role of these factors for pancreatic cancer.
Some studies suggest that heavy alcohol use is linked with a higher risk for pancreatic cancer. This may be related to the fact that heavy alcohol use is a common cause of chronic pancreatitis.
Physical inactivity @(Model.HeadingTag)>
Research suggests that people who are physically active on a regular basis may have a lower risk for pancreatic cancer.
Eating processed meat @(Model.HeadingTag)>
Several studies show a link between processed meats and a higher risk for pancreatic cancer.
Occupational exposure to chemicals @(Model.HeadingTag)>
Studies show that occupational exposure to some chemicals for more than 10 years increases the risk of developing pancreatic cancer. These chemicals include:
- petroleum compounds and solvents
- some dyes
- chemicals for metal refining
- polycyclic aromatic hydrocarbons and chlorinated hydrocarbons
Helicobacter pylori @(Model.HeadingTag)>
Helicobacter pylori (H. pylori) is a bacterium that grows in the inner lining of the stomach. Some studies show a link between H. pylori infection and a higher risk for pancreatic cancer.
Hepatitis B virus (HBV) @(Model.HeadingTag)>
HBV is a viral infection of the liver. Some studies suggest that infection with HBV increases the risk for pancreatic cancer.
Gum disease @(Model.HeadingTag)>
Researchers are studying possible connections between gum (periodontal) disease and certain health conditions. Some studies suggest that gum disease, or the bacteria linked with gum disease, is associated with a higher risk for pancreatic cancer.
Cystic fibrosis @(Model.HeadingTag)>
Cystic fibrosis is a genetic disease that affects glands that make mucus and sweat, which affects how well the lungs and digestive tract function. People with cystic fibrosis may have a higher risk of developing certain cancers, including pancreatic cancer, if they live with the disease for a long time.
Cirrhosis of the liver @(Model.HeadingTag)>
Cirrhosis is when scar tissue replaces healthy liver tissue. The scar tissue blocks blood flow through the liver so it can’t function normally. Cirrhosis is caused by long-term damage to liver tissues, such as drinking too much alcohol or being infected with hepatitis B or C viruses. Research shows that cirrhosis increases the risk for liver cancer, but it may also increase the risk for pancreatic cancer.
Unknown risk factors @(Model.HeadingTag)>
It isn’t known whether or not the following factors are linked with pancreatic cancer. It may be that researchers can’t show a definite link or that studies have had different results. More research is needed to see if the following are risk factors for pancreatic cancer:
- surgery to remove the gallbladder (called cholecystectomy)
- exposure to pesticides
Pancreatic cancer. Adami, H.-O., Hunter, D., & Trichopoulos, D. Textbook of Cancer Epidemiology. 2nd ed. Oxford: Oxford University Press; 2008: 13: 333-343.
Anderson, K. E. et al . Pancreatic cancer risk: associations with meat-derived carcinogen intake in the Prostate, Lung, Colorectal, and Ovarian cancer screening trial (PLCO) cohort. Molecular Carcinogenesis. Wiley; 2012.
Anderson, K.E., Mack, T.M., & Silverman, D.T. . Cancer of the pancreas. Schottenfeld, D. & Fraumeni, J. F. Jr. (eds.). Cancer Epidemiology and Prevention. 3rd ed. New York: Oxford University Press; 2006: 38: pp. 721-762.
Andreotti G, Silverman DT . Occupational risk factors and pancreatic cancer: a review of recent findings. Molecular Carcinogenesis. Wiley; 2012.
Antwi SO, Eckert EC, Sabaque CV, et al . Exposure to environmental chemicals and heavy metals and risk of pancreatic cancer. Cancer Causes and Control. 2015.
Arem H, Reedy J, Sampson J, Jiao L, Hollenbeck AR, Risch H et al . The Healthy Eating Index 2005 and risk for pancreatic cancer in the NIH-AARP study. Journal of the National Cancer Institute. 2013.
Becker AE, Hernandez YG, Frucht H, Lucas AL . Pancreatic ductal adenocarcinoma: risk factors, screening and early detection. World Journal of Gastroenterology. 2014.
Chang JS, T CR, Chen LT, Shan YS . Investigating the association between periodontal disease and the risk of pancreatic cancer. Pancreas. 2016.
Chen XA, Wang R, Chen HN, Hu JK . Cytotoxin-associated gene A-negative strains of Helicobacter pylori as a potential risk factor of pancreatic cancer. Pancreas. 2015.
Cogliano VJ, Baan R, Straif K, et al . Preventable exposures associated with human cancers. Journal of the National Cancer Institute. Oxford University Press; 2011.
Dragovich T, Harris JE, et al . Pancreatic cancer. eMedicine.com. Omaha: eMedicine, Inc; 2011.
Farris MS, Mosli MH, McFadden AA, Friedenreich CM, Brenner DR . The association between leisure time physical activity and pancreatic cancer risk in adults: a systematic review and meta-analysis. Cancer Epidemiology, Biomarkers and Prevention. 2015.
Guertin KA, Freedman ND, Loftfield E, Stolzenberg-Solomon RZ, Graubard BI, Sinha R . A prospective study of coffee intake and pancreatic cancer: results from the NIA-AARP Diet and Health Study. BJC. 2015.
Heinen MM, Verhage BA, Goldbohm RA, et al . Physical activity, energy restriction, and the risk of pancreatic cancer: a prospective study in the Netherlands. American Journal of Clinical Nutrition. The American Society for Nutrition; 2011.
Hodgin MB . Pancreatic cancer. Yarbro, CH, Wujcki D, & Holmes Gobel B (eds.). Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett; 2011: 63:1580-98.
IARC Monographs . Carcinogenicity of consumption of red and processed meat. Lancet. Elsevier; 2015.
International Agency for Research on Cancer (IARC). Volume 88: Formaldehyde, 2-butoxyethanol and 1-tert-butoxypropan-2-ol. 2006: http://monographs.iarc.fr/ENG/Monographs/vol88/mono88.pdf.
International Agency for Research on Cancer (IARC). Volume 100E: Personal Habits and Indoor Combustions. 2012: http://monographs.iarc.fr/ENG/Monographs/vol100E/mono100E.pdf.
International Agency for Research on Cancer (IARC). Volume 100B: Biological agents: a review of human carcinogens. 2012: http://monographs.iarc.fr/ENG/Monographs/vol100B/mono100B.pdf.
International Agency for Research on Cancer (IARC). Volume 114 Red Meat and Processed Meat. 2018: http://monographs.iarc.fr/ENG/Monographs/vol114/mono114.pdf.
Jiao L, Stolzenberg-Solomon R, Zimmerman TP, et al . Dietary consumption of advanced glycation end products and pancreatic cancer in the prospective NIH-AARP diet and health study. American Journal of Clinical Nutrition. 2015.
Ko AH, Tempero MA, Mulvihill SJ . Pancreas. Ko, A. H., Dollinger, M., & Rosenbaum, E. Everyone's Guide to Cancer Therapy: How Cancer is Diagnosed, Treated and Managed Day to Day. 5th ed. Kansas City: Andrews McMeel Publishing; 2008: 770-778.
Lerro CC, Koutros S, Andreotti G, Hines CJ, Blair A, Lubin J et al . Use of acetochlor and cancer incidence in the Agricultural Health Study. International Journal of Cancer. 2015.
Lin CC, Chiang JH, Li CI, Hsieh TF, Liu CS et al . Independent and joint effect of type 2 diabetes and gastric and hepatobiliary diseases on risk of pancreatic cancer risk: 10-year follow-up of population-based cohort. BJC. 2014.
Maisonneuve P, Lowenfels AB . Risk factors for pancreatic cancer: a summary review of meta-analytical studies. International Journal of Epidemiology. 2015.
Maisonneuve P, Marshall BC, Lowenfels AB . Risk of pancreatic cancer in patients with cystic fibrosis. Gut. 2007.
McWilliams RR, Petersen GM, Rabe KG, et al . Cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations and risk for pancreatic adenocarcinoma. Cancer. 2010.
Michaud DS . Role of bacterial infections in pancreatic cancer. Carcinogenesis. 2013.
Michaud DS, Izard J, Wilhelm-Benartzi CS, You, DH, Grote VA, Dahm CC, et al . Plasma antibodies to oral bacteria and risk of pancreatic cancer in a large European prospective cohort study. Gut. 2013.
Munigala S, Kanwal F, Xian H, Scherrer JF, Agarwal B . Increased risk of pancreatic adenocarcinoma after acute pancreatitis. Clinical Gastroenterology and Hepatology. 2014.
Noor NM, Banim PJR, Luben RN, Khaw KT, Hart AR . Investigating physical activity in the etiology of pancreatic cancer: the age at which this is measured is important and is independent of body mass index. Pancreas. 2016.
O'Rorke MA, Cantwell MM, Cardwell CR, Mulholland HG . Can physical activity modulate pancreatic cancer risk? a systematic review and meta-analysis. International Journal of Cancer. 2009.
Risch HA, Lu L, Kidd, MS, Wang J, Zhang W et al . Helicobacter pylori seropositivities and risk of pancreatic carcinoma. Cancer Epidemiology, Biomarkers and Prevention. 2014.
Rohrmann S, Linseisen J, Nothlings U, Overvad K, Egeberg R, et al . Meat and fish consumption and risk of pancreatic cancer: results from the European Prospective Investigation into Cancer and Nutrition. International Journal of Cancer. 2013: http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1097-0215.
Sahlman P, Nissinen M, Pukkala E, Farkkila M . Cancer incidence among alcoholic liver disease patients in Finland: a retrospective registry study during years 1996-2013. International Journal of Cancer. 2016.
Wexler, A., Waltzman, R.J., Macdonald, J. S. . Unusual pancreatic tumors. Raghavan, E., Brecher, M. L., Johnson, D. H., et al. (Eds.). Textbook of Uncommon Cancer. 3rd ed. Chichester, England: John Wiley & Sons; 2006: 6:32 pp. 367-382.
Winter JM, Brody JR, Abrams RA, Lewis NL, Yeo CJ . Cancer of the pancreas. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 49: 657-684.
World Cancer Research Fund (WCRF) / American Institute for Cancer Research (AICR). Continuous Update Project Report Summary. Food, Nutrition, Physical Activity, and the Prevention of Pancreatic Cancer. WCRF / AICR; 2012.
Zavoral M, Minarikova P, Zavada F, Salek C, Minarik M . Molecular biology of pancreatic cancer. World Journal of Gastroenterology. 2011.