Pancreatic cancer risk factors

Age

Risk increases as you age.

The likelihood of developing pancreatic cancer increases with age. The average age of being diagnosed with pancreatic cancer is 75, but younger people are still at risk.

As we age, our immune system declines in the sense that it becomes less efficient. This increases our risk of getting infections, diseases and cancers. The way our cells grow and divide is controlled by our genes (a gene is a short section of DNA). As we age, our DNA can become damaged, increasing our risk of cancer. Cells that help fight infection and regulate how they grow, reproduce and die, and also deteriorate as we age, increasing our risk of cancer.

Genetics

Passed on through a parent or relative.

Most cases of pancreatic cancer are not inherited, however, these are some genetic conditions and family traits which can give you a higher chance of getting the disease. Genetics are non-modifiable: You cannot change the genes you inherit. However, you can manage your risk once you are aware of it.

Pancreatic cancer runs in some families and this is called familial pancreatic cancer. People with first degree relatives (mother, father, brother, sister) diagnosed with pancreatic cancer have an increased chance of developing pancreatic cancer themselves. The greater the number of first-degree relatives with pancreatic cancer, the greater this risk is.

Family history is a strong predictor of pancreatic cancer risk because it is suggestive of the presence of a genetic link to pancreatic cancer. Unfortunately, there is currently no widely agreed reliable genetic test for pancreatic cancer. In many families, the genes that might cause pancreatic cancer are unknown. Research by EUROPAC (European Registry of Hereditary Pancreatitis and Familial Pancreatic Cancer) aims to identify gene changes that may increase risk in these families. This may be a way to get involved and check your family’s genes.

Smoking

Cigarettes, pipes and chewing tobacco.

The proportion of adults aged 16-years and above who said they smoked cigarettes in Great Britain was 14.5% in 2020.

Research has considered smoking to be the greatest, modifiable risk factor for pancreatic cancer. This is partly due to the carcinogenic compounds in cigarettes: These are the compounds that cause cancer. These compounds either damage DNA (directly or indirectly), which causes mutations in cells or by changing how cells reproduce and die. When cells grow and multiply beyond control, tumours develop.

Those who smoke are at a greater risk of developing pancreatic cancer than those who have never smoked. However, this risk can be decreased by quitting smoking, and after 20-years, the risk could equal that of someone who has never smoked.

Second-hand smoke (the inhalation of smoke) has also been found to cause pancreatic cancer. Children and unborn babies exposed to tobacco from people who smoke frequently may have an increased likelihood of the disease in adulthood.

Diabetes

Research shows that new-onset diabetes occurs in up to 30% of pancreatic cancer patients.

Type 2 diabetes is a symptom of pancreatic cancer, especially for those with a low or reducing BMI.

Research shows that new-onset diabetes has been identified to occur in up to 30% of pancreatic cancer patients and is something that can be detected in the presymptomatic phase.

In some cases, this can be up to two years before the cancer is discovered.

Excessive alcohol consumption

Heavy alcohol use.

Around 24% of adults in England and Scotland regularly drink at levels that increase their risk of ill health.

Alcohol is a known carcinogen, but the relationship between alcohol consumption and pancreatic cancer remains relatively unclear. Some studies have shown a link between heavy alcohol use and pancreatic cancer. However, there appears to be a greater link between alcohol consumption and pancreatitis, which is also a risk factor for pancreatic cancer. Therefore, pancreatitis may explain the link between alcohol consumption and pancreatic cancer. However, research has also indicated that the volume of alcohol consumption would need to be extreme for it to be an independent risk of pancreatic cancer.

Obesity

BMI of 30 or greater.

28% of adults in England are obese and a further 36% are overweight.

Obesity has been found to increase the risk in approximately 12% of all pancreatic cancers. Some large population studies suggest that the risk due to obesity may be much higher. The risk is also higher the more weight you gain and the longer you are overweight for. Research has suggested that the risk is increased through possible mechanisms, such as inflammation of the pancreas and insulin resistance.

Weight loss is a protective factor in that the more you lose, the lower your risk of developing pancreatic cancer can be.

Pancreatitis

Swelling and soreness of the pancreas.

The pancreas is vital for digesting food and managing your body’s use of sugar for energy after digestion. Pancreatitis is an inflammation (swelling and soreness) of the pancreas.

There are two main types, acute pancreatitis and chronic pancreatitis

Acute pancreatitis:
• Sudden, severe pain in centre of stomach
• Stomach swelling
• Nausea/vomiting
• Diarrhoea
• Indigestion
• High Temperature- above 37.5 °C
• Jaundice - yellowing of eyes & skin

Chronic pancreatitis
• Frequent episodes of stomach pain
• Recurring Indigestion
• Recurring nausea & vomiting
• Weight loss
• Jaundice
• Loss of appetite
• Needing to urinate often*
• Fatigue*
• Being thirsty*

* Symptoms of new onset diabetes

Chronic pancreatitis is linked to an increased risk of pancreatic cancer but the reasons why this is the case are still unclear and research is still ongoing.

The symptoms of pancreatitis and pancreatic cancer are very similar so should always be investigated to identify the cause as early as possible.