Epidemiology, Risk Factors and Clinical Presentation
Pancreatic cancer (PDAC) is a deadly disease. It has an incidence ranging 8–12 per 100,000 per year, with a similar mortality, as more than 95% of patients diagnosed with PDAC will ultimately die. Prevention policies are therefore particularly important and they should be distinguished in: (1) Primary prevention, aimed at reducing risk factors for PDAC and possibly favouring protective habits. (2) Secondary prevention, aimed at the early diagnosis through appropriate screening tests in subjects with a particularly high risk. The most important risk factors for pancreatic cancer are family history of pancreatic cancer, smoking, obesity, diabetes, alcohol and chronic pancreatitis. Diabetes of recent onset should be considered a possible alarm symptom. In patients with defined genetic syndromes such as “familiar pancreatic cancer”, and Peutz–Jeghers syndrome screening for pancreatic cancer as a part of research protocols are performed in selected Centres. There are no sufficient data to suggest that vitamins or aspirin may have a role for PDAC chemoprevention.
KeywordsPancreatic Cancer Chronic Pancreatitis Cystic Fibrosis Transmembrane Conductance Regulator Familial Adenomatous Polyposis PDAC Patient
- Bonovas S, Filioussi K, Sitaras NM (2008) Statins are not associated with a reduced risk of pancreatic cancer at the population level, when taken at low doses for managing hypercholesterolemia: evidence from a meta-analysis of 12 studies. Am J Gastroenterol 103(10):2646–2651PubMedCrossRefGoogle Scholar
- Brand RE, Lerch MM, Rubinstein WS, Neoptolemos JP, Whitcomb DC, Hruban RH, Brentnall TA, Lynch HT, Canto MI, Participants of the Fourth International Symposium of Inherited Diseases of the Pancreas (2007) Advances in counselling and surveillance of patients at risk for pancreatic cancer. Gut 56(10):1460–1469PubMedCentralPubMedCrossRefGoogle Scholar
- Canto MI, Goggins M, Hruban RH, Petersen GM, Giardiello FM, Yeo C, Fishman EK, Brune K, Axilbund J, Griffin C, Ali S, Richman J, Jagannath S, Kantsevoy SV, Kalloo AN (2006) Screening for early pancreatic neoplasia in high-risk individuals: a prospective controlled study. Clin Gastroenterol Hepatol 4(6):684–687CrossRefGoogle Scholar
- Del Chiaro M, Zerbi A, Falconi M, Bertacca L, Polese M, Sartori N, Boggi U, Casari G, Longoni BM, Salvia R, Caligo MA, Di Carlo V, Pederzoli P, Presciuttini S, Mosca F (2007) Cancer risk among the relatives of patients with pancreatic ductal adenocarcinoma. Pancreatology 7(5–6):459–469PubMedGoogle Scholar
- Genkinger JM, Spiegelman D, Anderson KE, Bergkvist L, Bernstein L, van den Brandt PA, English DR, Freudenheim JL, Fuchs CS, Giles GG, Giovannucci E, Hankinson SE, Horn-Ross PL, Leitzmann M, Männistö S, Marshall JR, McCullough ML, Miller AB, Reding DJ, Robien K, Rohan TE, Schatzkin A, Stevens VL, Stolzenberg-Solomon RZ, Verhage BA, Wolk A, Ziegler RG, Smith-Warner SA (2009) Alcohol intake and pancreatic cancer risk: a pooled analysis of fourteen cohort studies. Cancer Epidemiol Biomarkers Prev 18(3):765–776PubMedCentralPubMedCrossRefGoogle Scholar