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Epidemiology of pancreatic cancer: an overview

Nature Reviews Gastroenterology & Hepatology volume 6, pages 699–708 (2009)Cite this article

Abstract

Pancreatic cancer, although infrequent, has an exceptionally high mortality rate, making it one of the four or five most common causes of cancer mortality in developed countries. The incidence of pancreatic cancer varies greatly across regions, which suggests roles for lifestyle factors, such as diet, or environmental factors, such as vitamin D exposure. Smoking is the most common known risk factor, and is the cause of 20–25% of all pancreatic tumors. Alcohol does not seem to be a risk factor, unless it leads to chronic pancreatitis, which is a probable risk factor. Long-standing diabetes increases the risk of pancreatic cancer, but can also be an early manifestation of pancreatic tumors. 5–10% of patients with pancreatic cancer have an underlying germline disorder, while the remaining percentage of cancer cases is thought to be caused by somatic mutations. Some individual studies suggest that mutations in various polymorphic genes can lead to small increases in the risk of pancreatic cancer, but these findings need to be replicated. Rising prevalence of smoking in developing countries, improved diagnosis and increasing population longevity are all likely to increase the global burden of pancreatic cancer in the coming decades.

Key Points

  • Despite its low incidence in developed countries, pancreatic cancer is associated with poor survival and ranks as the fourth or fifth most common cause of cancer mortality

  • Smoking causes 20–25% of pancreatic cancer cases and is the most frequent cause of this tumor, yet it is the most preventable

  • Chronic pancreatitis and diabetes are two benign diseases that have been linked to pancreatic cancer

  • 5–10% of patients with pancreatic cancer have an underlying germline disorder, while the remaining cases seem to result from damage to genes occurred during life

  • Some apparently sporadic pancreatic cancers may in fact be caused by the interaction of polymorphic genes with other genes or with environmental factors

  • Potentially important risk factors that need further study include Helicobacter pylori and viral infections, and drugs such as aspirin, NSAIDS, and statins

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Figure 1: Global age-standardized incidence rates of pancreatic cancer in men, based on data from 235 global cancer registries in 40 countries.

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Acknowledgements

The authors were supported by grants from the C. D. Smithers Foundation and Solvay Pharmaceuticals.

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Authors and Affiliations

  1. Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy

    Sara Raimondi & Patrick Maisonneuve

  2. Departments of Surgery and Community Medicine, New York Medical College, Valhalla, NY, USA

    Albert B. Lowenfels

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  1. Sara Raimondi
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  2. Patrick Maisonneuve
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  3. Albert B. Lowenfels
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Correspondence to Sara Raimondi.

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Raimondi, S., Maisonneuve, P. & Lowenfels, A. Epidemiology of pancreatic cancer: an overview. Nat Rev Gastroenterol Hepatol 6, 699–708 (2009). https://doi.org/10.1038/nrgastro.2009.177

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