This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science
This page was updated on May 10, 2022.
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 of pancreatic cancer are largely unknown at this time, cancer is a disease that's caused by DNA mutations. Studies have identified many risk factors that may lead to these mutations and the development of pancreatic cancer. This guide covers the risk factors for developing pancreatic cancer and the findings of recent research.
About 67,440 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.
Risk factors are characteristics and conditions that increase a person’s risk for developing a disease. Pancreatic cancer risk factors include some that can’t be changed, such as having a family history of pancreatic cancer, being a man and getting older. But other risk factors may be changed to help lower the likelihood of developing pancreatic cancer. Doctors don’t know why some people with risk factors don’t get pancreatic cancer and why others with no risk factors do. Still, people can make certain lifestyle choices to try to lower their risk.
Modifiable risk factors are those that people may manage or change to lower the risk for developing this disease. They include those listed below.
Smoking is one of the major risk factors associated with pancreatic cancer. Smokers have double the risk for developing pancreatic cancer compared with nonsmokers, with a quarter of pancreatic cancers caused by cigarette smoking, according to ACS.
Quitting tobacco may decrease pancreatic cancer 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 the risk of pancreatic cancer.
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 associated with BMI. Compared with a person of standard weight (BMI of 18.5 to less than 25), an individual with a BMI of 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 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 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.
Some risk factors for pancreatic cancer simply can’t be changed. These include the following.
The average age for a pancreatic cancer diagnosis is 70. Almost all patients are older than 45 at the time of diagnosis, and the risk of developing pancreatic cancer increases with advancing age. Pancreatic cancer is most frequently diagnosed in people 65 to 74 years old, according to the ACS.
Males are more likely to develop pancreatic cancer than females. This may be due to higher tobacco usage rates in men. In 2023, about 33,130 men and 30,920 women are estimated to be diagnosed with pancreatic cancer, according to the ACS.
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.
For some people, pancreatic cancer is hereditary. In fact, up to 10 percent of all pancreatic cancers may result from genetic mutations passed from parent to child.
People 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. But the vast majority of pancreatic cancers are not a result of family genetics but other causes.
A few genetic syndromes that may cause pancreatic cancer include:
A 2018 systematic review and meta-analysis in The Lancet Oncology demonstrates patients with cystic fibrosis have an increased risk of pancreatic cancer.
People 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.
For the following potential pancreatic cancer risk factors, research is ongoing.
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, so more research is needed.
Some early research hinted that coffee may affect risk for developing pancreatic cancer, but the largest study to date published in 2015 in British Journal of Cancer shows no such link between total, caffeinated or decaffeinated coffee intake and pancreatic cancer risk.
Data regarding alcohol consumption—and its association with pancreatic cancer development—have 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 heavy drinkers who were drinking nine or more drinks per day.
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 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 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 a patient has 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 to learn more about the risk for developing pancreatic cancer and how to manage it.
