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Pancreatic cancer has few controllable risk factors. But it’s still important to know your risk.

See what your deCODEme genetic risk results could look like

Choose a healthy lifestyle to protect against pancreatic cancer as well as other diseases.

Several factors can affect the risk of developing non-endocrine pancreas cancer – including common genetic variants

Pancreatic cancer has several established risk factors

Although scientists still do not know exactly what causes most cases of pancreatic cancer, they have identified several risk factors that are significantly associated with this disease. Research has shown that some of these risk factors affect the DNA of pancreatic cells, which may lead to the development of pancreatic tumors. As in most cancers, the risk factors for pancreatic cancer include ones that cannot be changed, but fortunately also some that can:

Non-modifiable risk factors

• Age: The risk of developing pancreatic cancer increases with age. Nearly 90% of those diagnosed are older than 55 years. The average age at the time of diagnosis is 72.
• Gender: Men are slightly more likely than women to develop pancreatic cancer. Since smoking is a prominent risk factor for pancreatic cancer, this may reflect the fact that more men have smoked in the past than women. The sex difference in pancreatic cancer risk was indeed more pronounced in the past (when tobacco use was much more common among men than women), but this gender gap in smoking has closed rapidly in recent years.
• Ethnicity: Males of African American descent are more likely to develop pancreatic cancer than people of European or Asian descent. The reasons are not clear, but it may be due in part to higher rates of smoking and diabetes among African American men.
• Family history: Pancreatic cancer sometimes runs in families. In some families, the high risk is due to a recognized inherited syndrome (see below). In others, the gene causing the increased risk of pancreatic cancer is not known.
• Blood group: Large epidemiological studies have found an association between ABO blood groups and the risk of developing pancreatic cancer (see e.g. here). According to these studies, people in blood groups A, B, or AB have a higher risk of developing pancreatic cancer than people in blood group O. In support of these findings, genetic researchers have recently identified a common genetic variant associated with increased pancreatic cancer risk in the ABO locus of 9q34 (Amundadottir et al, 2010), which is included in the deCODEme genetic scan. The mechanism behind this association between the ABO locus and pancreatic cancer is, however, not yet known.
• Genetic syndromes: Rare mutations in a handful of known genes may cause as many as 5% of pancreatic cancers, in addition to causing other problems. Examples of the genetic syndromes that can lead to non-endocrine pancreatic cancer are listed below. None of the extremely rare genetic variants underlying these sydromes are included in the deCODEme genetic scan. They can be screened by other types of genetic tests.
  • Hereditary breast and ovarian cancer syndrome, caused by mutations in the BRCA2 gene
  • Familial melanoma, caused by mutations in the CDKN2A gene (also known as p16, a tumor suppressor gene).
  • Familial pancreatitis, caused by mutations in the PRSS1 gene
  • Hereditary non-polyposis colorectal cancer (HNPCC), also known as Lynch syndrome, is most often caused by a mutation in either the MLH1 gene or the MSH2 gene . At least 5 other genes can also cause HNPCC.
  • Peutz-Jeghers syndrome (PJS), caused by mutations in the STK1 gene.
  • Von Hippel-Lindau disease, caused by mutations in the VHL gene.

Modifiable risk factors

• Cigarette smoking: The risk of developing pancreatic cancer is 2 to 3 times higher among smokers than among non-smokers. Scientists think that this may be due to carcinogenic chemicals in cigarette smoke that enter the blood and damage the pancreatic cells. About 20% to 30% of non-endocrine (exocrine) pancreatic cancers are thought to be caused by cigarette smoking. Many experts think that smoking explains the increased rate of pancreatic cancer in the last 50 years, which is only now starting to decline as smoking rates have dropped. People who use smokeless tobacco are also more likely to get non-endocrine pancreatic cancer.
• Obesity: Very overweight (obese) people are more likely to develop exocrine pancreatic cancer.
• Lack of exercise: Exercise lowers the risk of this cancer.
• Diabetes: Non-endocrine pancreatic cancer is more common in people with diabetes, particularly people with type 2 diabetes, the type that usually starts in adulthood and is linked to obesity. The reason for this association is not known and it is not clear if people with type 1 diabetes have a higher than average risk.
• Chronic pancreatitis: is a long-term inflammation of the pancreas. This condition is associated with an increased risk of pancreatic cancer, although most people with pancreatitis never develop pancreatic cancer. The link between chronic pancreatitis and pancreatic cancer is strongest in smokers.
• Cirrhosis of the liver: Cirrhosis is a scarring of the liver. It occurs in people with liver damage from hepatitis and excessive 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.
• Stomach problems: Infection of the stomach with the ulcer-causing bacteria Helicobacter pylori (H. pylori) may increase the risk of developing pancreatic cancer. Some researchers believe that excess stomach acid may also increase this risk.
• Diet: Some studies have found an association between pancreatic cancer and high-fat diets, or diets rich in 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. However, not all studies have found such associations, and the exact role of diet in relation to pancreatic cancer is still under study.
• Alcohol: Few studies have found evidence of an association between alcohol use and pancreatic cancer. However, heavy alcohol use can increase the risk of diabetes, liver cirrhosis, and chronic pancreatitis, which are all risk factors for pancreatic cancer.

More information on pancreatic cancer risk factors

• Calculate you pancreatic cancer risk – Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
• Pancreatic cancer risk factors – Cancer Research UK
• Pancreatic cancer risk factors – Mayo Clinic
• What are the risk factors for pancreatic cancer – The American Cancer Society

This content was last reviewed on February 18, 2010.

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