How diet, nutrition and physical activity affect pancreatic cancer risk.
The pancreas is an elongated gland located behind the stomach. It contains two types of tissue, exocrine and endocrine.
The exocrine pancreas produces digestive enzymes that are secreted into the small intestine. Cells in the endocrine pancreas produce hormones including insulin and glucagon, which influence glucose metabolism.
In addition to the findings on diet, nutrition and physical activity outlined above, other established causes of pancreatic cancer include:
Tobacco use is an established cause of pancreatic cancer and approximately 25% of cases of pancreatic cancer are attributable to tobacco smoking.
More than 90% of pancreatic cancer cases are sporadic (due to spontaneous rather than inherited mutations), although a family history increases risk, particularly where more than one family member is involved.
Pathogenesis: how does pancreatic cancer develop?
The ductal cells in the head of the pancreas are exposed to pancreatic secretions, as well as bile, and environmental carcinogens can reach these cells through these fluids or the blood, through which endogenous factors may also act.
The pancreas is relatively inaccessible to routine medical examination, so the progression of this cancer through precursor lesions is not well understood. However, inflammation is implicated in this process through chronic pancreatitis, which is a risk factor for pancreatic cancer. The role of infection with Helicobacter pylori is the subject of ongoing research. Conditions characterised by high insulin secretion, such as insulin resistance and type 2 diabetes, are associated with the risk of this cancer.
Full references and a summary of the mechanisms underpinning all the findings can be found in the pancreatic cancer report.
In 2018, World Cancer Research Fund International published Diet, Nutrition, Physical Activity and Cancer: a Global Perspective on behalf of AICR, WCRF and WKOF. This was the third in our series of major reports looking at the many ways in which our diets, and how active we are, affect our cancer risk. You can find out much more about pancreatic cancer by downloading a pdf of the relevant chapter in the 2018 report. Please note, however, that this webpage may have been updated since the report was published.
Published findings in peer-reviewed journals
Selected findings from this report have been published in peer-reviewed journals. Details of the papers and links to the abstract in PubMed are below:
Height and pancreatic cancer risk: a systematic review and meta-analysis of cohort studies. Aune D, Vieira AR, Chan DS, Navarro-Rosenblatt DA, Vieira R, Greenwood DC, Cade JE, Burley VJ & Norat T. Cancer Causes Control. 2012; 23(8): 1213-22. Abstract
Dietary fructose, carbohydrates, glycemic indices and pancreatic cancer risk: a systematic review and meta-analysis of cohort studies. Aune D, Chan DS, Vieira AR, Navarro-Rosenblatt DA, Vieira R, Greenwood DC, Cade JE, Burley VJ & Norat T. Ann Oncol. 2012; 23(10): 2536-46. Abstract
Body mass index, abdominal fatness and pancreatic cancer risk: a systematic review and non-linear dose-response meta-analysis of prospective studies. Aune D, Greenwood DC, Chan DS, Vieira R, Vieira AR, Navarro-Rosenblatt DA, Cade JE, Burley VJ & Norat T. Ann Oncol. 2011; 23(4): 843-52. Abstract