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School of Medicine
Certain factors may increase your chances of developing pancreatic cancer. Risk factors that have been scientifically proven to have biological or genetic links to causing pancreatic cancer are cigarette smoking, chronic pancreatitis and family history.
Risk Factors include:
- Cigarette smoking
- Chronic inflammation of the pancreas (pancreatitis)
- Family history (five to 10 percent of pancreatic cancers are inherited)
- Age (most cases develop between age 60 and 80)
- Gender (it is more common in men)
- African Americans also have higher incidences
- Individuals of Jewish descent are prone to an inherited mutation in the BRCA2 gene
- Peptic ulcer surgery
- Diets high in meats and cholesterol-laden, fried foods
Knowing your family history of disease is important. Up to 10% of pancreatic cancers are inherited from parent to child. We are learning about specific instruction in DNA, called genes, that are associated with inherited cancers.
- Individuals with 2 or more first-degree relatives (parent, sibling, or child) who have had pancreatic cancer have an increased risk of developing pancreatic cancer.
- Individuals with 3 or more close relatives (aunts, uncles, grandparents) are also at risk.
- In addition, there are some inherited genes that are associated with an increased risk of multiple cancers.
- Individuals who have a young family member under the age of 50 with any of the following cancers: breast, pancreatic, colon cancer, or melanoma, should have a discussion with their physician to determine if they are at increased risk for an inherited cancer.
Johns Hopkins experts are studying family risk and causes for pancreatic cancer. The National Familial Pancreas Tumor Registry at Johns Hopkins began in 1994 when the importance of familial clustering and pancreatic cancer was recognized. We believe that there is likely to be a genetic cause behind this clustering. With our research in hand, we are working on ways to improve our methods of genetic counseling and screening methods for pancreatic cancer.
We are also on the hunt for additional pancreatic cancer genes through genotyping technology and gene sequencing.
Since lifestyle factors may be important, we collect information from our patients about habits and health history so that we can study all the causes of this disease.
If you have immediate or close family members with pancreatic cancer and would like to learn more about your risk for pancreatic cancer, contact our Cancer Risk Assessment Program to make an appointment. If you are not in the mid-Atlantic region and are seeking genetic counseling services in your area, a directory of professionals can be found through the National Cancer Institute or National Society of Genetic Counselors.
Scientific studies have shown that excessive alcohol drinking leads to chronic pancreatitis. Pancreatitis is inflammation of the pancreas. When inflammation occurs, inflammatory cells secrete growth factors and toxins. After many years of chronic inflammation in the pancreas, these growth factors and toxins cause genetic damage and uncontrolled growth of pancreatic cells. This can lead to pancreatic cancer. It is important to note that it takes many years of chronic pancreatitis to increase risk for pancreatic cancer.
It is not clear how much alcohol causes chronic pancreatitis. Some experts recommend avoiding drinking more than 1 drink a day for women and more than 2 drinks a day for men. However, chronic pancreatitis and pancreatic cancer is associated with large amounts of alcohol taken over a long period of time.
A few studies have suggested a link between soft drinks and pancreatic cancer, but much more research is needed to understand and confirm this link. However, most experts recommend avoiding drinking too many high calorie soft drinks to promote a healthy lifestyle and avoid many diseases, including obesity and possibly diabetes.
Some studies have linked Type-2 diabetes to pancreatic cancer, but more studies are needed to better understand the role it plays in causing pancreatic cancer. Type-2 diabetes occurs when the hormone insulin does not work as well to process sugars in the body. Insulin works by making cells grow and live longer. Cancer cells work the same way. More research is needed to understand the potential link between diabetes and pancreatic cancer.
A small percentage of pancreatic cysts (or intraductal papillary mucinous neoplasms) will become precancerous or cancerous. Johns Hopkins investigators estimate that fluid-filled cysts are identified in more than a million patients each year, most of whom have undergone CT or MRI scans to evaluate non-specific symptoms, such as abdominal pain and swelling.
Johns Hopkins experts have developed a Multidisciplinary Pancreatic Cyst Program to evaluate patients with known or suspected pancreatic cysts. The program offers a comprehensive evaluation, incorporating all aspects of care from top experts in the field. In addition, Johns Hopkins scientists have created a gene-based test to distinguish harmless from precancerous pancreatic cysts. The test may eventually help some patients avoid needless surgery to remove the harmless variety. More research is needed before the test can be developed and used for evaluating cysts in patients.