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The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on March 24, 2021.

Risk factors for pancreatic cancer

A pancreatic cancer diagnosis may spark a number of questions and concerns: How did this happen? What caused the cancer? What are the risk factors? 


While the causes are largely unknown at this time, many risk factors associated with pancreatic cancer have been studied and identified. Learn about the basics of pancreatic cancer, as well as the risk factors and the latest research. 


Pancreatic cancer: The basics

The pancreas is a gland in the abdomen that makes enzymes for digestion and hormones that control sugar levels in the blood. Benign or malignant tumors may form if the process of cellular division in this gland breaks down. Malignant tumors of the pancreas are called pancreatic cancer.  


About 60,000 Americans will be diagnosed with pancreatic cancer this year, according to the American Cancer Society (ACS). Pancreatic cancer accounts for 3 percent of all cancers in the United States and for about 7 percent of all cancer deaths.


The two major types of pancreatic cancer are the exocrine tumor (the most common) and the neuroendocrine tumor, or islet cell tumor. They are determined by the type of cell in which they originate, and specific risk factors may be related to each type.  


Initial signs and symptoms are often vague and include: 

  • Pain
  • Weight loss
  • Jaundice (yellowing of the skin or eyes)
  • Loss of appetite
  • Nausea
  • Vomiting
  • Recent-onset diabetes
  • Changes in the stool

A diagnosis is usually determined through imaging and tissue sampling. Possible treatment options include surgery, chemotherapy and radiation


Speaking with a physician or genetic counselor may be helpful for you to learn more about your risk for pancreatic cancer and the ways in which you may keep yourself healthy. 

Modifiable risk factors

Modifiable risk factors are those you may manage or change to lower your risk of this disease. They include:

Cigarette smoking 

Smoking is one of the major risk factors associated with pancreatic cancer. Smokers have double the risk of developing pancreatic cancer compared with nonsmokers, and a quarter of pancreatic cancers are thought to be caused by cigarette smoking, according to ACS.


If you smoke, quitting tobacco may decrease your risk. A large Dutch study published in 2010 in Cancer Epidemiology, Biomarkers & Prevention found that quitting smoking gradually reduces the risk of pancreatic cancer. After 20 years, a previous smoker’s risk is the same as that of someone who never smoked. The message to current smokers is clear: Quitting smoking helps reduce your risk of pancreatic cancer. 

Obesity and physical inactivity 

Being overweight and having little physical activity are also risk factors for pancreatic cancer. Several studies suggest a link, with many specifically pointing to an individual’s body mass index (BMI). 


In a 2010 study in Cancer Causes & Control, researchers noted an increase in pancreatic cancer risk related with BMI. Compared with a person of standard weight (BMI 18.5 to less than 25), an individual with a BMI from 25 to less than 30 had a 13 percent increased risk of pancreatic cancer. A person with a BMI of 30 to less than 35 had a 19 percent increased risk. 

Diabetes

Diabetes has been studied extensively in relation to pancreatic cancer. An increased risk is typically found in individuals with type 2 diabetes, according to ACS.  


A 2014 review in the Annals of Surgical Oncology examined and pooled information from 88 studies on the topic, finding that diabetic patients had double the risk of developing pancreatic cancer as compared with nondiabetic patients. 


Another reverse association may be in play—in certain patients, diabetes may be an early manifestation of pancreatic cancer. Authors of a 2013 study, also published in the Annals of Surgical Oncology, noted that certain pancreatic cancer patients had a history of newly diagnosed diabetes. 


Surgery to correct the cancer also corrected the diabetes in a proportion of these patients. In these cases, pancreatic cancer may have been causing the late-onset diabetes, and this is a possible prognostic factor. It’s important to note that this is not the case with all pancreatic cancer patients, and more research is underway in this area. 

Chronic pancreatitis

Chronic inflammation of the pancreas, known as chronic pancreatitis, is a risk factor for pancreatic cancer. Chronic pancreatitis is often associated with heavy alcohol use and smoking, according to ACS. 


Non-modifiable risk factors

Some risk factors for pancreatic cancer you simply can’t change. These include: 

Age, gender and race 

The average age for a pancreatic cancer diagnosis is 70. Almost all patients are older than 45, and the risk of developing pancreatic cancer increases with age. 


Men are more likely to develop pancreatic cancer than women. This may be due to higher tobacco usage rates in men. 


African-Americans have higher rates of pancreatic cancer than Caucasians. While the reason is unknown, it may be related to higher rates of diabetes or smoking among these populations. 

Family history and genetic predisposition syndromes 

Up to 10 percent of all pancreatic cancers may result from genetic mutations passed from parent to child, according to ACS. Patients with a family history fall into two big categories: defined syndromes that lead to an increased risk of pancreatic cancer, or familial pancreatic cancer for which no specific molecular cause has yet been identified. 


A few genetic syndromes that may cause pancreatic cancer include: 

  • Hereditary breast and ovarian cancer (HBOC) syndrome
  • Hereditary breast cancer
  • Familial atypical multiple mole melanoma (FAMMM) syndrome
  • Familial pancreatitis
  • Lynch syndrome
  • Peutz-Jeghers syndrome 

Cystic fibrosis 

A 2018 systematic review and meta-analysis in The Lancet Oncology demonstrates patients with cystic fibrosis have an increased risk of pancreatic cancer. 

Pancreatic cysts 

Patients with a specific type of pancreatic cystic neoplasm, called intraductal papillary mucinous neoplasm of the pancreas (IPMN), are at risk for developing pancreatic cancer from one of these cysts, according to 2017 research published in Gastroenterology. When this happens, the cancer is usually called IPMN-associated adenocarcinoma. These patients are also at risk for developing conventional pancreatic cancer. 


Risk factors that are unclear or need additional research

For these potential risk factors, research is ongoing: 

Diet 

A Western diet heavy in processed meat, saturated fats and sugary drinks may increase the risk of pancreatic cancer, according to ACS. However, not all studies link the two together, so more research is needed. 

Coffee and alcohol consumption

As with diet, data regarding coffee and alcohol consumption—and its association with pancreatic cancer development—has been conflicting. Some studies are not statistically significant, and others show only a very small increase in risk. 


If alcohol does have a specific impact, it’s likely to be found in heavy drinkers. According to a 2012 study in the Annals of Oncology, researchers only noticed increased risk in the group of heavy drinkers who were drinking nine or more drinks per day. 

Infections 

Infections involving the Helicobacter pylori (H. pylori) bacteria or the hepatitis B and C viruses have been studied as potential risk factors for pancreatic cancer. For all three of these infections, however, more robust studies are needed, according to ACS. 

Blood type

Blood is categorized through the ABO blood group system. In a large 2009 analysis in the Journal of the National Cancer Institute, scientists examined two previous studies that had collected blood from more than 100,000 U.S. health professionals and examined the association between certain blood types and pancreatic cancer development. 


Compared with blood group O, those with blood groups A, AB or B were more likely to develop pancreatic cancer. That said, more research is needed to explore how exactly this happens. 

Screening

Screening for pancreatic cancer is usually reserved for very specific cases. The first step may involve genetic testing because of a family history of the disease, according to ACS. If you have a high risk for pancreatic cancer, two common tests—an endoscopic ultrasound or a magnetic resonance imaging (MRI) scan—may be used to screen for early pancreatic cancer. 


These methods are not used to screen the general public at average risk, only individuals who are at high risk. Speaking with a physician or genetic counselor may be helpful for you to learn more about your risk for pancreatic cancer and how you can manage it.