What are the causes and risk factors for pancreatic cancer ?
The risk factors for pancreatic cancer are multiple. Some of these factors are directly related to an individual's constitution (constitutional factors), while others are linked to the environment (environmental factors). It is the interaction between constitutional and environmental factors that leads to the development of pancreatic cancer.
Among the constitutional factors, it is estimated that 5% to 10% of pancreatic cancers occur in the context of suspected or proven genetic predisposition. These are referred to as hereditary or familial forms of cancer. Hereditary forms are caused by mutations that are passed down from one generation to the next and are involved in the development of cancer.
TO REMIND YOU
DNA is a collection of 3 billion molecules that are at the "core," more specifically in the nucleus of each of the 30 trillion cells that make up our body. This DNA consists of a sequence of 4 different elements named A, T, G, and C, after the first letter of their full names. It forms a double helix and contains all the information necessary for the functioning of each cell.
This information is contained in small fragments of DNA called " genes ". There are about 21,000 genes that determine how a cell functions and the production of proteins, which are essential components of cells.
When cells divide, mutations can occur in the DNA, changing one element for another within one or more genes. These mutations can be passed down from parent to child ( hereditary genetic mutations ) or occur spontaneously in an individual during their lifetime ( sporadic mutations ). Some mutations may increase the risk of developing cancers.
Hereditary forms of pancreatic cancer are rare. They are associated with well-defined conditions that increase the risk of pancreatic cancer.
For example, this is the case with Lynch syndrome, which is also responsible for 3 to 5% of colorectal cancers. It is also true for Li-Fraumeni syndrome and hereditary chronic pancreatitis.
Familial forms may be due to a mutation, family lifestyle factors, chance, or a combination of these factors.
In the case of pancreatic cancer, there are familial clusters of pancreatic cancer cases with an unknown origin. The higher the number of family members affected by pancreatic cancer, the greater the risk of developing the disease. Familial pancreatic cancer is defined when at least two first-degree relatives (father, mother, brother, sister, or child) have pancreatic cancer.
Among other constitutional factors, as with most cancers, age is an important risk factor: more than 8 out of 10 cases occur between the ages of 60 and 80.
Sex is also a constitutional factor, as pancreatic cancer is more common in men than in women. Additionally, pancreatic cancer is more frequent among Black individuals, Ashkenazi Jews, and Sephardic Jews (Source: arcagy.com).
Among environmental factors, there is, for reasons that are still unclear, an increased risk of pancreatic cancer in patients with type 1 and type 2 diabetes. This excess risk is about 2 times higher compared to non-diabetic individuals.
As with many cancers, obesity is a risk factor.
Tobacco use is also a clearly established risk factor: smoking from adolescence increases the risk of pancreatic cancer by 2 to 5 times. The risk increase depends on both the duration and the amount of smoking.
Chronic pancreatitis, inflammation of the pancreas most often caused by alcohol consumption, also increases the risk of pancreatic cancer.
Exposure to heavy metals or nickel is associated with an increased risk of about 2 times.
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Article updated on Jan 21, 2025
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