Pancreatic cancer has a very poor long-term survival. The incidence rate varies between countries, which may implicate environmental factors. The incidence of pancreatic cancer is also strongly age-dependent. Smoking is a major risk factor along with chronic pancreatitis and longstanding type 2 diabetes. In recent years several inherited disorders have been linked with pancreatic cancer, including hereditary pancreatitis and other genetic syndromes. In order to reduce the risk of pancreatic cancer, lifestyle alterations are needed and secondary screening may have a role in high-risk individuals with a genetic predisposition to develop pancreatic cancer.
Pancreatic cancer represents an important health problem as it is the fourth and sixth most common cause of cancer-related mortality in the USA. The overall 5-year survival is less than 5%. Only 10–20% of individuals undergo potentially curative resection and most of them will have recurrent disease within a year. It is a uniformly fatal disease as the incidence and mortality are roughly equivalent. In 2002, there were 232.000 new cases of pancreatic cancer and 227.000 deaths worldwide. In the USA in 2006, there were 33.730 new cases and 32.300 deaths.
Age
The peak incidence occurs in those aged 65–75 years. The world incidence in men over 65 years old is 35 per 100.000 population per year and in women are 29 per 100.000.
Gender
Pancreatic cancer occurs more frequently in men than women, although some area variations exist.
Demography and Race
The highest incidence for men is reported in eastern Europe and North America and the lowest in Southeast Asia and southern/ northern Africa.
Risk Factors
- Inherited predisposition.
- Chronic pancreatitis.
- Impaired glucose metabolism.
- Previous gastric surgery.
- Gallstones and previous cholecystectomy.
- Primary sclerosing cholangitis.
- Dietary and nutritional factors, such as high meat consumption or consumption of deep-fried and grilled foods, carcinogenic substances related to meat preparation methods (nitrosamines, polycyclic aromatic hydrocarbons, and heterocyclic aromatic amines), and heavy alcohol use. There were no associations of pancreatic cancer risk with intake of poultry, fish, dairy products, eggs, total fat, saturated fat, or cholesterol.
- Tobacco smoking.
- Occupation and chemical exposure.
- Helicobacter pylori seropositivity.
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