Causes and risk of pancreatic cancer

Pancreatic cancer is the 11th most common cancer in the UK. Over 7,600 people a year get it. It is more common in older people, with 80% of patients over 60. It is uncommon in people under 40.

Causes

We are still trying to determine the causes of pancreatic cancer, and for this more research is required. We have learned that mutations in the DNA of pancreatic cells play a large role in the development of cancer and that these mutations cause pancreatic cells to behave abnormally. These DNA mutations may be caused by our habits or environment (e.g. smoking) or less commonly may be inherited. The mutations cause pancreatic cells to grow in a rapid uncontrolled manner, eventually developing into a mass or tumour which no longer works the same way as the original damaged cell. For this reason the research work PCUK supports is vital; in order to find more effective treatments, a better understanding of the causes of pancreatic cancer is critical.

 

Risks

Despite the fact that the causes are poorly understood, there are things that do increase the risk of developing pancreatic cancer.

Smoking
Up to 1 in 5 (20%) of pancreatic cancers may be linked to smoking (cigarettes, cigars and chewing tobacco increase the risk).

Diabetes
Diabetes is a disease of the endocrine function of the pancreas in the cells that usually make insulin. Diabetes is a common disease and there may be a slight increased risk of developing pancreatic cancer. It is also possible that the cancer causes some cases of diabetes. If you are over 50, develop diabetes and start losing weight for no obvious reason, your doctor should check you out for other pancreatic disease.

Diet, body weight and exercise
A number of lifestyle related factors may increase the risk of developing pancreatic cancer including a diet that is high in saturated fat and sugar, not eating enough fresh vegetables and fruit (this is also true for other cancer types) and being overweight and doing little or no exercise. Tomatoes which contain a substance called Lycopene and Vitamin C may give you added protection against developing pancreatic cancer.

Other medical conditions

Chronic pancreatitis (long-term inflammation of the pancreas) - can increase the risk of developing pancreatic cancer.

Hereditary pancreatitis - a rare condition, typically develops at a early age with recurrent episodes of chronic pancreatitis. It is likely that 4 out of 10 people with this condition will develop pancreatic cancer.

 

Hereditary factors

It is thought that about 1 person in 10 who develops pancreatic cancer does so because of inherited factors. Most of these are due to the occurrence of very rare medical disorders. Such as:

Familial cancer syndromes
Where an inherited faulty gene causes a number of different cancers to develop within the members of one family, these include

  • the BRCA2 gene which is linked to breast, ovarian and prostate cancer
  • hereditary non-polyposis colorectal cancer
  • familial adenomatous polyposis
  • familial atypical mole and melanoma
  • Peutz-Jeghers syndrome which also causes polyps in the stomach and intestines

Hereditary Pancreatitis
A rare condition in which family members develop pancreatitis because of a faulty gene

Hereditary Pancreatic Neuroendocrine Tumours
Including multiple endocrine neoplasia type 1 (MEN-1) and von Hippel-Lindau disease (VHL), neurofibromatosis type 1 and tuberous sclerosis.

Familial Pancreatic Cancer
Some families don't have any of these medical conditions but have at least two first degree relatives affected by pancreatic cancer. (A first degree relative is a father, mother, son, daughter, brother or sister.) These families may have familial pancreatic cancer. We don't know which gene or genes are linked to familial pancreatic cancer, and this is an active area of research.

It is recommended that if your family may have an increased risk of pancreatic cancer you are referred to a specialist cancer genetics centre, where you will be counselled about your personal risk and offered the chance to take part in screening. See the section on screening for further information.