Understanding Types of Risk Factors

There are two main types of risk factors:

  • Modifiable: those you can change, like lifestyle choices
  • Non-modifiable: those you cannot change such as your genes or family history.

Having risk factors doesn’t mean you will definitely get pancreatic cancer. Many people with one or more risk factors never develop the disease, and some individuals with pancreatic cancer might not have had any identifiable risk factors. For example, smokers may have a higher relative risk of developing pancreatic cancer than non-smokers. However, this doesn’t mean all smokers will develop the disease; it simply means their risk is higher than the general population.

Understanding your risk factors is crucial for making informed decisions about your health. By being aware of the factors you can control, such as smoking, diet and exercise, you can take steps to reduce your risk. At the same time, recognising the factors you can’t change, like your genetic makeup or family history, can help you and your doctor stay alert for early signs and symptoms of pancreatic cancer.

Non-modifiable Risk Factors for Pancreatic Cancer Include:

  • Age: The risk of developing pancreatic cancer increases with age. Most people who are diagnosed with pancreatic cancer are over 60 years old, and 50% of cases are diagnosed in individuals aged 71 and over.
  • Family history and genetic syndromes: Pancreatic cancer may run in the family and/or may be linked with genetic conditions that increase the risk of other types of cancer. This is called familial pancreatic cancer. Approximately 10% of individuals with pancreatic cancer report a family history of pancreatic cancer. If you have a child, sibling, or parent who has been diagnosed with pancreatic cancer, your own risk of developing it might be higher, especially if more than one family member has had it.
  • Individuals with certain genetic syndromes are also at higher risk of developing pancreatic cancer. Examples of genetic syndromes that can lead to pancreatic cancer include:
    • Hereditary breast and ovarian cancer syndrome, caused by mutations in the BRCA1 or BRCA2 genes.
    • Hereditary breast cancer, caused by mutations in the PALB2 gene.
    • Familial atypical multiple mole melanoma (FAMMM) syndrome, caused by mutations in the p16/CDKN2A gene.
    • Familial pancreatitis, usually caused by mutations in the PRSS1 gene
    • Lynch syndrome, also known as hereditary non-polyposis colorectal cancer (HNPCC), most often caused by a defect in the MLH1 or MSH2 genes
    • Peutz-Jeghers syndrome, caused by defects in the STK11 gene.
  • Diabetes: People who have had diabetes for over five years are more likely to develop pancreatic cancer. A sudden onset of type 2 diabetes in someone over 50, especially if they are losing weight or don’t have a family history of diabetes, may also be an early sign of pancreatic cancer.
  • Pancreatitis: People with chronic or hereditary pancreatitis have a higher risk of developing pancreatic cancer. Chronic pancreatitis is inflammation of the pancreas that keeps coming back over time. It is common in people who consume large amounts of alcohol over many years. Familial pancreatitis is a hereditary condition, usually beginning by the time a person is aged 20 years old.
  • Pancreatic cyst: Pancreatic cysts are fluid-filled growths on or inside the pancreas. Most of them are benign, meaning they are not cancerous. However, some cysts can turn into cancer. Not all pancreatic cysts increase the risk of pancreatic cancer, but a few types do, such as mucinous cystic neoplasms (MCNs), intraductal papillary mucinous neoplasms (IPMNs) and solid pseudopapillary neoplasms. 

Pancreatic cysts

Modifiable Risk Factors for Pancreatic Cancer Include

  • Obesity: People who have a BMI over 30 kg/m2 are about 20% more likely to develop pancreatic cancer compared to those with a healthy weight. The risk is even higher for those who are obese in their early adult years.
  • Smoking: People who smoke are twice as likely to develop pancreatic cancer than those who don’t. However, if you quit smoking, your risk decreases over time.
  • Alcohol consumption: Research indicates that heavy drinking may be linked to a higher chance of developing pancreatic cancer. People who consume more than four standard alcoholic drinks a day have a greater risk of developing pancreatic cancer. Heavy alcohol consumption can also cause illnesses like chronic pancreatitis, known to increase the risk of developing pancreatic cancer.
  • Exposure to certain pesticides, dyes, or chemicals: Working with or being exposed to specific types of chemicals, such as certain pesticides and dyes, may increase the risk of pancreatic cancer. These substances can be harmful to the body’s cells and may cause mutations or damage that leads to cancer.

Ways to Lower Your Risk

  • Quit smoking: Smoking is the most important avoidable risk factor for pancreatic cancer. Not smoking is the best way to lower your risk for pancreatic cancer. If you smoke and want help quitting, please talk to your doctor or call the Quitline on 13 QUIT (13 7848).
  • Maintain a healthy weight: To lower your risk of cancer, it’s important to maintain a healthy weight. Your doctor can help you with advice on maintaining a healthy weight. Being overweight can make your body less responsive to insulin, a hormone that controls blood sugar levels. This causes your pancreas to make more insulin, and high levels of a hormone similar to insulin (insulin-like growth factor 1) can help cancer cells grow.
  • Healthy diet: A high dietary intake of fresh fruit and vegetables has been shown to reduce the risk of developing pancreatic cancer. Avoid eating too much red and processed meat, and drinking too many sugary drinks, as these have been shown to increase the risk of developing pancreatic cancer.
  • Avoid heavy alcohol consumption: Heavy drinking can lead to conditions like chronic pancreatitis, which increases the risk of pancreatic cancer. If you choose to drink, limit your intake to no more than 10 standard drinks a week and no more than 4 standard drinks a day.
  • Limit exposure to harmful chemicals: Wear personal protective equipment when handling certain pesticides, dyes or chemicals.
  • Key references
    • https://www.canceraustralia.gov.au/cancer-types/pancreatic-cancer/statistics
    • Dbouk M, Katona BW, Brand RE, Chak A, Syngal S, Farrell JJ, Kastrinos F, Stoffel EM, Blackford AL, Rustgi AK, Dudley B, Lee LS, Chhoda A, Kwon R, Ginsberg GG, Klein AP, Kamel I, Hruban RH, He J, Shin EJ, Lennon AM, Canto MI, Goggins M. The Multicenter Cancer of Pancreas Screening Study: Impact on Stage and Survival. J Clin Oncol. 2022 Oct 1;40(28):3257-3266. Doi: 10.1200/JCO.22.00298. Epub 2022 Jun 15. PMID: 35704792; PMCID: PMC9553376.
    • Yadav D, Lowenfels AB. The epidemiology of pancreatitis and pancreatic cancer. Gastroenterology. 2013 Jun;144(6):1252-61. Doi: 10.1053/j.gastro.2013.01.068. PMID: 23622135; PMCID: PMC3662544.
    • Rawla P, Sunkara T, Gaduputi V. Epidemiology of Pancreatic Cancer: Global Trends, Etiology and Risk Factors. World J Oncol. 2019 Feb;10(1):10-27. Doi: 10.14740/wjon1166. Epub 2019 Feb 26. PMID: 30834048; PMCID: PMC6396775.
    • Andreotti G, Silverman DT. Occupational risk factors and pancreatic cancer: a review of recent findings. Mol Carcinog. 2012 Jan;51(1):98-108. doi: 10.1002/mc.20779. PMID: 22162234; PMCID: PMC6394840.
    • Andreotti G, Freeman LE, Hou L, Coble J, Rusiecki J, Hoppin JA, Silverman DT, Alavanja MC. Agricultural pesticide use and pancreatic cancer risk in the Agricultural Health Study Cohort. Int J Cancer. 2009 May 15;124(10):2495-500. doi: 10.1002/ijc.24185. PMID: 19142867; PMCID: PMC2674312.