Pancreatic Cancer: What Causes It?

A mix of genes and environmental risk factors contribute to this often deadly form of cancer.

医学专家不知道why people get pancreatic cancer, but they’ve made strides in figuring out the biological underpinnings of the disease and the factors that raise a person’s risk of getting it.

As with other forms of cancer, pancreatic cancer results from alterations (mutations) in the DNA of certain pancreatic cells. These genetic mutations instruct the cells to multiply wildly and form malignant tumors.

Is pancreatic cancer hereditary? Researchers estimate that about 10 percent of the time, the answer is yes, gene mutations that raise susceptibility to the disease are passed down from parent to child.

一项研究于2018年6月发表在美国医学协会杂志identified six genes with an association with pancreatic cancer. (1) In the study, the genes were identified at a higher rate in people with a family history of the disease.

Pancreatic cancer can also be the result of genetic mutations that occur during one’s lifetime, for a variety of reasons related to environmental exposures or lifestyle choices, such as cigarette smoking.

For many patients, the pancreaticcancer causeis unknown. Researchers believe the trigger for the disease may be a random event that occurs spontaneously within cells. (2)

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What Raises Pancreatic Cancer Risk?

In the general population, a person with an average chance of developing pancreatic cancer.

But there are a number of factors that can raise the odds:

• AgeThe older you are, the greater your possibility of developing pancreatic cancer. Around 90 percent of people who get the disease are older than 55, while 70 percent are older than 65. But younger people can get pancreatic cancer, too.
• GenderMen are more likely to develop pancreatic cancer than women. In 2018 an estimated 29,200 men and 26,240 women in the United States will be diagnosed with the disease.（（3)
• Race and Ethnicity与亚洲，西班牙裔或白人相比，黑人患胰腺癌的风险更高。Ashkenazi犹太背景的男人和女人也更加脆弱。这可能是由于基因突变（BRCA2）也与乳腺，卵巢和前列腺癌, which is found in about 1 percent of people with this heritage.
• SmokingSmokers have double the pancreatic cancer risk of nonsmokers; about 20 to 30 percent of pancreatic cancers are associated with cigarette smoking. Cigars, pipes, and smokeless tobacco products may also be problematic.
• Obesity and DietObese people are about 20 percent more likely to develop pancreatic cancer. Men and women who are overweight (but not obese) are at higher risk as well, and may be especially so if they carry the extra pounds around their waists. While more research is needed on the link between pancreatic cancer and diet, some studies have connected the disease to high consumption of fatty foods or a diet high in red or processed meats (such as sausage) and low in fruits and vegetables.
• DiabetesThere is a significant amount of evidence linking diabetes with pancreatic cancer, especially for people who have the condition for many years. The sudden onset of diabetes may also be asymptom of pancreatic cancer。
• Family HistoryPancreatic cancer can run in families, most likely because of shared genetic mutations. This condition, called familial pancreatic cancer (FPC), accounts for about 10 percent of all cases. Families are considered to have FPC if there are two or more first-degree relatives (parent, child, sibling) who have beendiagnosed with pancreatic cancer, or if there are three or more close relatives from the same side of the family with a pancreatic-cancer diagnosis. (4)
• Chronic PancreatitisThis painful inflammation of thepancreas, which can be brought on by alcohol abuse, has been linked to pancreatic cancer.
• Rare Inherited ConditionsThese include hereditarypancreatitis, Peutz-Jeghers syndrome, familial malignantmelanoma和胰腺癌，遗传性乳房和ovarian cancersyndrome, and Lynch syndrome.
• Workplace ChemicalsThe American Cancer Society singles out chemicals related to dry cleaning and metal working as particularly hazardous.
• BacteriaA common bacterium calledHelicobacter pylori（（H. pylori) causes inflammation andulcersin the stomach and can also, to a lesser extent, raise pancreatic-cancer risk.
• Hepatitis B InfectionThere is some evidence linking the virus to pancreatic cancer, although more research is needed.
• Cirrhosis这种情况通常是由于酒精滥用引起的，当肝细胞损伤导致疤痕组织时会出现。（（5)

Can You Prevent Pancreatic Cancer?

Researchers are working to develop reliable detection tests that can catch pancreatic cancer at its earliest stages, when it is most treatable. The hope is to identify indicators of the disease — also known as biomarkers — that would be detectable through ablood testor analysis of another substance in the body.

在这些测试可用之前，处于高风险的人（由于家庭的突变（例如或罕见的遗传疾病））可能能够参与使用各种成像方法的调查筛查程序，例如内窥镜检查超声andCT scans。（（6)

But while risk factors like family history can’t be changed, there are a number of things that anyone can do to minimize their chances of developing pancreatic cancer:

• Don’t smoke.This is the most significant thing you can do to lower your pancreatic cancer risk.
• Maintain a healthy weight.为了帮助实现这一目标，美国癌症协会建议遵循强调植物食品的健康饮食，其中至少包括2½cups of fruits and vegetables a day. The guidelines oncancer preventionalso recommend choosing whole-grain breads, pastas, and cereals instead of refined grains, and opting for fish, poultry, or beans rather than processed meat and red meat.
• Limit alcohol.Some (but not all) studies have found an association between heavy alcohol consumption and pancreatic cancer.
• Avoid hazardous workplace chemicals.Minimize your exposure to chemicals that are known or suspected to be carcinogenic. (7)