Pancreatic cancer accounts for only 2% of cancers diagnosed in the United States each year; however, it is the fifth leading cause of cancer death in this country. According to the American Cancer Society's most recent estimates for pancreatic cancer in the United States, more than:
- 42,000 cases are diagnosed each year
- 35,000 people die because of the disease
The lifetime risk of having pancreatic cancer is about 1 in 72. It is about the same for men and women. The risk increases with age, and most cases are diagnosed between 60 and 80 years old. Pancreatic cancer usually has few, if any, signs or symptoms in the early stages when it would be most treatable.
The pancreas is a spongy, oblong organ about 6 inches long and 2 inches wide. It is located behind the lower part of the stomach, between the stomach and the spine. The pancreas is important because it makes insulin and other hormones that help the body absorb sugar and control blood sugar, and produces juices that aid in digestion.
Pancreatic Cancer Types
The pancreas contains two main types of cells:
- Exocrine cells, which make digestive juices
- Endocrine cells, which produce hormones
Almost all pancreatic cancers start in exocrine cells. These cells line the pancreatic duct (duct cells), through which pancreatic juices with digestive enzymes flow.
Adenocarcinoma is cancer of the exocrine cells. It accounts for 95% of pancreatic cancers.
Islet cell carcinoma involves endocrine cells. Most islet cell tumors are malignant, but some are benign, such as insulin-producing islet cell tumors. Tumors can be:
- Functional and produce abnormally high amounts of hormones
- Non-functional and produce no hormones
Pancreaticoblastoma is very rare. This type of pancreatic cancer is found mostly in young children.
Isolated sarcomas and lymphomas can occur in the pancreas. These are very rare.
Pseudopapillary neoplasms occur mostly in young women in their teens and 20s.
Ampullary cancer: This rare type of exocrine tumor begins where the bile duct (from the liver) and the pancreatic duct join with the small intestine. Since it causes yellowing of the skin and eyes, it may be found earlier than other types of pancreatic cancer.
Pancreatic Cancer Risk Factors
Anything that increases your chance of getting pancreatic cancer is a risk factor. While the precise causes of pancreatic cancer have not been determined, MD Anderson is researching risk factors and has made several landmark discoveries. Risk factors for pancreatic cancer include:
Age: The risk of pancreatic cancer increases sharply after 50 years old. At the time of diagnosis, almost 90% of patients are older than 55.
Race: African-Americans are more likely to have pancreatic cancer than other ethnic groups.
Smoking and tobacco use: People who smoke are two to three times more likely to develop pancreatic cancer. Smokeless tobacco also increases risk. Read more about MD Anderson’s smoking cessation clinical trials
Family history: Pancreatic cancer seems to run in some families, and some research shows that about 10% are caused by hereditary gene changes. The exact genes have not been fully identified, but changes in DNA that increase a person's risk for other types of cancer may increase the risk of pancreatic cancer. Gene mutations that seem to increase risk for pancreatic cancer include:
- K-ras, found in most cases of pancreatic ductal adenocarcinomas
- BRCA2, often found in families with high rates of breast, ovarian and prostate cancers. BRCA2 seems to be more common in people with Ashkenazi Jewish or Eastern European heritage
- Peutz-Jeghers syndrome and other rare genetic syndromes
Other hereditary conditions that might mean higher risk of pancreatic cancer include:
- Hereditary pancreatitis
- Multiple endocrine neoplasia type 1 syndrome
- Hereditary nonpolyposis colon cancer (HNPCC, also called Lynch syndrome)
- Von Hippel-Lindau syndrome
- Familial atypical multiple mole melanoma syndrome (FAMMM)
- Obesity: People who are very overweight and have a body mass index (BMI) more than 30 are more likely to develop pancreatic cancer. It is also is found more often in people who do not exercise regularly.
Sudden onset diabetes: Diabetes can be both a risk factor and an early symptom of pancreatic cancer. The exact relationship between diabetes and pancreatic cancer is being studied, but it may be caused by high concentrations of insulin or other hormones. In diabetics, sudden changes in blood sugar control may also be a risk factor
Environmental exposure to certain pesticides, dyes, and chemicals
Not everyone with risk factors gets pancreatic cancer. However, if you have risk factors, you should discuss them with your doctor.
Pancreatic Cancer Prevention
The number one way to prevent pancreatic cancer is to stop smoking. Read more about MD Anderson’s smoking cessation clinical trials. Other lifestyle choices may lower your chances of getting pancreatic cancer, including:
- Eating a healthy diet
- Maintaining a healthy weight
- Getting regular exercise
Behavioral and lifestyle changes can help prevent pancreatic cancer. Visit our prevention and screening section to learn how to manage your risk.
Some cases of pancreatic cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.