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.
Incidence and survival rates
Cancer of the pancreas is the 12th most common type of cancer worldwide. About 338,000 cases were recorded in 2012, accounting for around 2 per cent of cancers overall. The incidence is somewhat higher in men than in women.
This cancer is almost always fatal and is the seventh most common cause of cancer death, accounting for 4 per cent of all cancer deaths.
Age-adjusted rates of pancreatic cancer have been generally stable since the 1970s, following an approximate threefold rise over the preceding 50 years in the countries for which data are available.
Pancreatic cancer is mainly a disease of high-income countries, where overall rates are nearly three times higher than in middle-and low-income countries.
Over 95 per cent of pancreatic cancers are adenocarcinomas of the exocrine pancreas, the type included in the CUP analyses.
Lifestyle factors and pancreatic cancer risk
In this report from our Continuous Update Project (CUP) – the world’s largest source of scientific research on cancer prevention and survivorship through diet, nutrition and physical activity – we analyse global research on how certain lifestyle factors affect the risk of developing pancreatic cancer. This webpage forms part of the World Cancer Research Fund/American Institute for Cancer Research Third Expert Report Diet, Nutrition, Physical Activity and Cancer: a Global Perspective.
Findings on pancreatic cancer
There is strong evidence that:
- being overweight or obese INCREASES the risk of pancreatic cancer
- being tall INCREASES the risk of pancreatic cancer
There is some evidence that:
- consumption of red meat might increase the risk of pancreatic cancer
- consumption of processed meat might increase the risk of pancreatic cancer
- consumption of foods containing saturated fatty acids might increase the risk of pancreatic cancer
- consumption of alcoholic drinks might increase the risk of pancreatic cancer
- consumption of foods and beverages containing fructose might increase the risk of pancreatic cancer
Other causes of pancreatic cancer
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 per cent of cases of pancreatic cancer are attributable to tobacco smoking.
- family history
More than 90 per cent 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.
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.
How the research was conducted
The global scientific research on diet, nutrition, physical activity and the risk of pancreatic cancer was systematically gathered and analysed, and then independently assessed by a panel of leading international scientists in order to draw conclusions about which of these factors increase or decrease the risk of developing this cancer.
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
This webpage is a summary.
For much more, download the full chapter.