Pancreatic cancer is one of the most difficult cancers to detect and treat. It begins in the pancreas, a small organ behind the stomach that makes substances needed for digestion and hormones such as insulin that help control blood sugar.
The most common form is pancreatic ductal adenocarcinoma, which starts in cells lining small tubes in the pancreas.
The disease often causes few clear symptoms at first, so many cases are discovered only after the cancer has grown or spread to other parts of the body.
There is usually no single cause of pancreatic cancer. Instead, the disease develops after cells collect harmful genetic changes, and several factors can make those changes more likely.
Smoking is one of the clearest preventable risk factors. According to the American Cancer Society, people who smoke have about twice the risk of pancreatic cancer as people who have never smoked, and smoking is thought to account for roughly one-quarter of cases.
Age also plays a major role. Pancreatic cancer is uncommon in younger adults, and most patients are older than 65 when they are diagnosed, partly because genetic damage can build up in cells over many years.
Family history can increase risk as well. People with several close relatives who have had pancreatic cancer may have inherited genetic changes that make the disease more likely, although many people diagnosed with the cancer have no strong family history.
Several inherited gene changes have been linked to pancreatic cancer, including changes involving BRCA1 and BRCA2. These genes are better known for their connection to breast and ovarian cancers, but they can also affect pancreatic cancer risk and may influence which treatments work best.
Long-lasting inflammation of the pancreas, known as chronic pancreatitis, is another risk factor. Repeated inflammation can damage pancreatic tissue over time, although most people with pancreatitis will never develop pancreatic cancer.
Excess body weight has also been associated with a higher risk. Maintaining a healthy weight through regular physical activity and a balanced diet may reduce the chance of several diseases, including some cancers, even though no particular food can guarantee protection from pancreatic cancer.
Diabetes has a complicated relationship with the disease. Long-standing type 2 diabetes is associated with a moderately higher risk, but pancreatic cancer itself can sometimes cause new diabetes or suddenly make existing diabetes harder to control.
For that reason, researchers are studying whether unexpected diabetes in older adults could sometimes provide an early warning sign. Most people who develop diabetes do not have pancreatic cancer, however, so diabetes alone should not be treated as evidence of cancer.
Some research has also examined workplace exposure to certain chemicals, including substances used in industries such as metalworking, dry cleaning and pesticide production. The evidence varies depending on the chemical and level of exposure, and scientists continue to investigate these possible risks.
Unlike breast or colorectal cancer, there is currently no routine screening test recommended for everyone at average risk of pancreatic cancer. People with a strong family history or certain inherited genetic conditions may qualify for specialized monitoring using imaging tests at experienced medical centers.
Possible symptoms include yellowing of the skin or eyes, unexplained weight loss, loss of appetite, pain in the abdomen or back, pale or greasy stools, and new or worsening diabetes. These symptoms can have many other causes, but persistent or unexplained changes should be discussed with a healthcare professional.
Research on pancreatic cancer risk, prevention and early detection is published across major medical journals, including Cancer Research, JAMA, The Lancet Oncology and Journal of Clinical Oncology. Scientists are continuing to study genetics, blood markers and advanced imaging in the hope of finding the disease earlier, when treatment has a better chance of success.
Although some risk factors, such as age and inherited genes, cannot be changed, others can. Avoiding tobacco, maintaining a healthy weight, limiting heavy alcohol use and managing existing health conditions are practical steps that can support overall health and may reduce pancreatic cancer risk.
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