What causes pancreatic cancer?

Updated: Oct 02, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Pancreatic cancers can arise from the exocrine and endocrine portions of the pancreas, but 93% of them develop from the exocrine portion, including the ductal epithelium, acinar cells, connective tissue, and lymphatic tissue. Approximately 75% of all pancreatic carcinomas occur within the head or neck of the pancreas, 15-20% occur in the body of the pancreas, and 5-10% occur in the tail.

Tobacco smoking is the most common recognized risk factors for pancreatic cancer. Others include obesity, high alcohol consumption, history of pancreatitis and diabetes, family history of pancreatic cancer, and possibly selected dietary factors. [12] Only 5-10% are hereditary in nature. [13]

Because excess risk for pancreatic cancer is greater in patients recently diagnosed with diabetes mellitus, it has been suggested that diabetes may be at least in part a consequence or an early manifestation of pancreatic cancer. However, the International Pancreatic Cancer Case-Control Consortium reported that a 30% excess risk for pancreatic cancer persists for more than 2 decades after diabetes diagnosis, which supports the hypothesis that diabetes has a causal role in pancreatic cancer. [14]

Less than 5% of all pancreatic cancers are related to underlying chronic pancreatitis. Alcohol consumption does not appear to be an independent risk factor for pancreatic cancer unless it is associated with chronic pancreatitis.

The risk factors for pancreatic cancer are discussed in more detail below.

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