Epidemiology and risk factors of pancreatic cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WU Wanlong ,  PENG Bing

Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

PENG Bing, Email: pengbing84@hotmail.com

Keywords：

pancreatic cancer; epidemiology; risk factor; review

DOI：

10.7507/1007-9424.201904016

Video：

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Objective This review aimed to summarize the current epidemiological status and risk factors of pancreatic cancer at home and abroad.Method The literatures on epidemiology and risk factors of pancreatic cancer in recent years were collected and summarized.Results Currently the overall incidence of pancreatic cancer was lower in all malignant tumors, but the mortality rate was the opposite. Incidence varies from region to region, the incidence rate in economically developed areas was higher than that of underdeveloped areas. Although the disease had made some progress in the fields of surgery, chemotherapy, an so on, the long-term survival of patients with pancreatic cancer was still not ideal. The onset of pancreatic cancer was associated with smoking, alcohol, obesity, dietary imbalance, age, gender, blood type, ethnicity, family history and genetic history, chronic pancreatitis, infection, and intestinal flora imbalance.Conclusions Pancreatic cancer is a high malignancy with a poor prognosis. It is influenced by a variety of risk factors. Therefore, it is especially necessary to pay attention to the primary prevention of pancreatic cancer and screen high-risk individuals regularly, to diagnose pancreatic cancer at an early stage.

Citation： WU Wanlong, PENG Bing. Epidemiology and risk factors of pancreatic cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(12): 1500-1504. doi: 10.7507/1007-9424.201904016 Copy

1.	Zeng H, Chen W, Zheng R, et al. Changing cancer survival in China during 2003-15: a pooled analysis of 17 population-based cancer registries. Lancet Glob Health, 2018, 6(5): e555-e567.
2.	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin, 2018, 68(1): 7-30.
3.	International Agency for Research on Cancer, World Health Organization. Global cancer observatory 2018. http://gco.iarc.fr/.
4.	Wong MCS, Jiang JY, Liang M, et al. Global temporal patterns of pancreatic cancer and association with socioeconomic development. Sci Rep, 2017, 7(1): 3165.
5.	Schmohl KA, Gupta A, Grünwald GK, et al. Imaging and targeted therapy of pancreatic ductal adenocarcinoma using the theranostic sodium iodide symporter (NIS) gene. Oncotarget, 2017, 8(20): 33393-33404.
6.	Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 2015, 136(5): E359-E386.
7.	Rahib L, Smith BD, Aizenberg R, et al. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res, 2014, 74(11): 2913-2921.
8.	Midha S, Chawla S, Garg PK. Modifiable and non-modifiable risk factors for pancreatic cancer: a review. Cancer Lett, 2016, 381(1): 269-277.
9.	Wolpin BM, Chan AT, Hartge P, et al. ABO blood group and the risk of pancreatic cancer. J Natl Cancer Inst, 2009, 101(6): 424-431.
10.	Wolpin BM, Kraft P, Gross M, et al. Pancreatic cancer risk and ABO blood group alleles: results from the pancreatic cancer cohort consortium. Cancer Res, 2010, 70(3): 1015-1023.
11.	Becker AE, Hernandez YG, Frucht H, et al. Pancreatic ductal adenocarcinoma: risk factors, screening, and early detection. World J Gastroenterol, 2014, 20(32): 11182-11198.
12.	王方华, 吴怡林, 龚建平. KRAS突变与胰腺癌的发生及治疗的研究进展. 中国普外基础与临床杂志, 2019, 26(6): 764-768.
13.	Riegert-Johnson DL, Westra W, Roberts M. High cancer risk and increased mortality in patients with Peutz-Jeghers syndrome. Gut, 2012, 61(2): 322.
14.	Bosetti C, Lucenteforte E, Silverman DT, et al. Cigarette smoking and pancreatic cancer: an analysis from the International Pancreatic Cancer Case-Control Consortium (Panc4). Ann Oncol, 2012, 23(7): 1880-1888.
15.	Allen NE, Beral V, Casabonne D, et al. Moderate alcohol intake and cancer incidence in women. J Natl Cancer Inst, 2009, 101(5): 296-305.
16.	Zheng W, McLaughlin JK, Gridley G, et al. A cohort study of smoking, alcohol consumption, and dietary factors for pancreatic cancer (United States). Cancer Causes Control, 1993, 4(5): 477-482.
17.	Harnack LJ, Anderson KE, Zheng W, et al. Smoking, alcohol, coffee, and tea intake and incidence of cancer of the exocrine pancreas: the Iowa Women’s Health Study. Cancer Epidemiol Biomarkers Prev, 1997, 6(12): 1081-1086.
18.	Heuch I, Kvåle G, Jacobsen BK, et al. Use of alcohol, tobacco and coffee, and risk of pancreatic cancer. Br J Cancer, 1983, 48(5): 637-643.
19.	Silverman DT, Brown LM, Hoover RN, et al. Alcohol and pancreatic cancer in blacks and whites in the United States. Cancer Res, 1995, 55(21): 4899-4905.
20.	Partanen TJ, Vainio HU, Ojajärvi IA, et al. Pancreas cancer, tobacco smoking and consumption of alcoholic beverages: a case-control study. Cancer Lett, 1997, 116(1): 27-32.
21.	Suzuki T, Matsuo K, Sawaki A, et al. Alcohol drinking and one-carbon metabolism-related gene polymorphisms on pancreatic cancer risk. Cancer Epidemiol Biomarkers Prev, 2008, 17(10): 2742-2747.
22.	Jiao L, Silverman DT, Schairer C, et al. Alcohol use and risk of pancreatic cancer: the NIH-AARP Diet and Health Study. Am J Epidemiol, 2009, 169(9): 1043-1051.
23.	Michaud DS, Vrieling A, Jiao L, et al. Alcohol intake and pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium (PanScan). Cancer Causes Control, 2010, 21(8): 1213-1225.
24.	Wang YT, Gou YW, Jin WW, et al. Association between alcohol intake and the risk of pancreatic cancer: a dose-response meta-analysis of cohort studies. BMC Cancer, 2016, 16: 212.
25.	WCRFI. Pancreatic cancer statistics. World cancer research fund international. 2015. http://www.wcrf.org/int/cancer-facts-figures/data-specific-cancers/pancreatic-cancerstatistics.
26.	Davoodi SH, Malek-Shahabi T, Malekshahi-Moghadam A, et al. Obesity as an important risk factor for certain types of cancer. Iran J Cancer Prev, 2013, 6(4): 186-194.
27.	Maisonneuve P, Lowenfels AB. Risk factors for pancreatic cancer: a summary review of meta-analytical studies. Int J Epidemiol, 2015, 44(1): 186-198.
28.	Paluszkiewicz P, Smolińska K, Dębińska I, et al. Main dietary compounds and pancreatic cancer risk. The quantitative analysis of case-control and cohort studies. Cancer Epidemiol, 2012, 36(1): 60-67.
29.	Bao Y, Hu FB, Giovannucci EL, et al. Nut consumption and risk of pancreatic cancer in women. Br J Cancer, 2013, 109(11): 2911-2916.
30.	Wu L, Wang Z, Zhu J, et al. Nut consumption and risk of cancer and type 2 diabetes: a systematic review and meta-analysis. Nutr Rev, 2015, 73(7): 409-425.
31.	Appleby PN, Crowe FL, Bradbury KE, et al. Mortality in vegetarians and comparable nonvegetarians in the United Kingdom. Am J Clin Nutr, 2016, 103(1): 218-230.
32.	Lightsey D, National Council Against Health Fraud and Quackwatch. Comment on ‘Red and processed meat consumption and risk of pancreatic cancer: meta-analysis of prospective studies’. Br J Cancer, 2012, 107(4): 754-755.
33.	Beaney AJ, Banim PJR, Luben R, et al. Higher meat intake is positively associated with higher risk of developing pancreatic cancer in an age-dependent manner and are modified by plasma antioxidants: a prospective cohort study (EPIC-Norfolk) using data from food diaries. Pancreas, 2017, 46(5): 672-678.
34.	Miller PE, Alexander D. A review and meta-analysis of prospective studies of red and processed meat and pancreatic cancer. FASEB J, 2016, 30: 902-909.
35.	Yorifuji T, Tsuda T, Doi H, et al. Cancer excess after arsenic exposure from contaminated milk powder. Environ Health Prev Med, 2011, 16(3): 164-170.
36.	Yorifuji T, Tsuda T, Grandjean P. Unusual cancer excess after neonatal arsenic exposure from contaminated milk powder. J Natl Cancer Inst, 2010, 102(5): 360-361.
37.	Burney PG, Comstock GW, Morris JS. Serologic precursors of cancer: serum micronutrients and the subsequent risk of pancreatic cancer. Am J Clin Nutr, 1989, 49(5): 895-900.
38.	Stevens RJ, Roddam AW, Beral V. Pancreatic cancer in type 1 and young-onset diabetes: systematic review and meta-analysis. Br J Cancer, 2007, 96(3): 507-509.
39.	Huxley R, Ansary-Moghaddam A, Berrington de González A, et al. Type-Ⅱ diabetes and pancreatic cancer: a meta-analysis of 36 studies. Br J Cancer, 2005, 92(11): 2076-2083.
40.	Li D, Tang H, Hassan MM, et al. Diabetes and risk of pancreatic cancer: a pooled analysis of three large case-control studies. Cancer Causes Control, 2011, 22(2): 189-197.
41.	Bosetti C, Rosato V, Li D, et al. Diabetes, antidiabetic medications, and pancreatic cancer risk: an analysis from the International Pancreatic Cancer Case-Control Consortium. Ann Oncol, 2014, 25(10): 2065-2072.
42.	Sharma A, Smyrk TC, Levy MJ, et al. Fasting blood glucose levels provide estimate of duration and progression of pancreatic cancer before diagnosis. Gastroenterology, 2018, 155(2): 490-500.
43.	Grote VA, Rohrmann S, Nieters A, et al. Diabetes mellitus, glycated haemoglobin and C-peptide levels in relation to pancreatic cancer risk: a study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Diabetologia, 2011, 54(12): 3037-3046.
44.	Midha S, Sreenivas V, Kabra M, et al. Genetically determined chronic pancreatitis but not alcoholic pancreatitis is a strong risk factor for pancreatic cancer. Pancreas, 2016, 45(10): 1478-1484.
45.	Raimondi S, Lowenfels AB, Morselli-Labate AM, et al. Pancreatic cancer in chronic pancreatitis; aetiology, incidence, and early detection. Best Pract Res Clin Gastroenterol, 2010, 24(3): 349-358.
46.	Fan X, Alekseyenko AV, Wu J, et al. Human oral microbiome and prospective risk for pancreatic cancer: a population-based nested case-control study. Gut, 2018, 67(1): 120-127.
47.	Memba R, Duggan SN, Ni Chonchubhair HM, et al. The potential role of gut microbiota in pancreatic disease: a systematic review. Pancreatology, 2017, 17(6): 867-874.
48.	Guo Y, Liu W, Wu J. Helicobacter pylori infection and pancreatic cancer risk: a meta-analysis. J Cancer Res Ther, 2016, 12(Supplement): C229-C232.
49.	曹成亮, 曲凤智, 王刚, 等. 幽门螺杆菌在胰腺癌发生发展中作用的研究进展. 中国普外基础与临床杂志, 2017, 24(10): 1275-1278.

1. Zeng H, Chen W, Zheng R, et al. Changing cancer survival in China during 2003-15: a pooled analysis of 17 population-based cancer registries. Lancet Glob Health, 2018, 6(5): e555-e567.
2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin, 2018, 68(1): 7-30.
3. International Agency for Research on Cancer, World Health Organization. Global cancer observatory 2018. http://gco.iarc.fr/.
4. Wong MCS, Jiang JY, Liang M, et al. Global temporal patterns of pancreatic cancer and association with socioeconomic development. Sci Rep, 2017, 7(1): 3165.
5. Schmohl KA, Gupta A, Grünwald GK, et al. Imaging and targeted therapy of pancreatic ductal adenocarcinoma using the theranostic sodium iodide symporter (NIS) gene. Oncotarget, 2017, 8(20): 33393-33404.
6. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 2015, 136(5): E359-E386.
7. Rahib L, Smith BD, Aizenberg R, et al. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res, 2014, 74(11): 2913-2921.
8. Midha S, Chawla S, Garg PK. Modifiable and non-modifiable risk factors for pancreatic cancer: a review. Cancer Lett, 2016, 381(1): 269-277.
9. Wolpin BM, Chan AT, Hartge P, et al. ABO blood group and the risk of pancreatic cancer. J Natl Cancer Inst, 2009, 101(6): 424-431.
10. Wolpin BM, Kraft P, Gross M, et al. Pancreatic cancer risk and ABO blood group alleles: results from the pancreatic cancer cohort consortium. Cancer Res, 2010, 70(3): 1015-1023.
11. Becker AE, Hernandez YG, Frucht H, et al. Pancreatic ductal adenocarcinoma: risk factors, screening, and early detection. World J Gastroenterol, 2014, 20(32): 11182-11198.
12. 王方华, 吴怡林, 龚建平. KRAS突变与胰腺癌的发生及治疗的研究进展. 中国普外基础与临床杂志, 2019, 26(6): 764-768.
13. Riegert-Johnson DL, Westra W, Roberts M. High cancer risk and increased mortality in patients with Peutz-Jeghers syndrome. Gut, 2012, 61(2): 322.
14. Bosetti C, Lucenteforte E, Silverman DT, et al. Cigarette smoking and pancreatic cancer: an analysis from the International Pancreatic Cancer Case-Control Consortium (Panc4). Ann Oncol, 2012, 23(7): 1880-1888.
15. Allen NE, Beral V, Casabonne D, et al. Moderate alcohol intake and cancer incidence in women. J Natl Cancer Inst, 2009, 101(5): 296-305.
16. Zheng W, McLaughlin JK, Gridley G, et al. A cohort study of smoking, alcohol consumption, and dietary factors for pancreatic cancer (United States). Cancer Causes Control, 1993, 4(5): 477-482.
17. Harnack LJ, Anderson KE, Zheng W, et al. Smoking, alcohol, coffee, and tea intake and incidence of cancer of the exocrine pancreas: the Iowa Women’s Health Study. Cancer Epidemiol Biomarkers Prev, 1997, 6(12): 1081-1086.
18. Heuch I, Kvåle G, Jacobsen BK, et al. Use of alcohol, tobacco and coffee, and risk of pancreatic cancer. Br J Cancer, 1983, 48(5): 637-643.
19. Silverman DT, Brown LM, Hoover RN, et al. Alcohol and pancreatic cancer in blacks and whites in the United States. Cancer Res, 1995, 55(21): 4899-4905.
20. Partanen TJ, Vainio HU, Ojajärvi IA, et al. Pancreas cancer, tobacco smoking and consumption of alcoholic beverages: a case-control study. Cancer Lett, 1997, 116(1): 27-32.
21. Suzuki T, Matsuo K, Sawaki A, et al. Alcohol drinking and one-carbon metabolism-related gene polymorphisms on pancreatic cancer risk. Cancer Epidemiol Biomarkers Prev, 2008, 17(10): 2742-2747.
22. Jiao L, Silverman DT, Schairer C, et al. Alcohol use and risk of pancreatic cancer: the NIH-AARP Diet and Health Study. Am J Epidemiol, 2009, 169(9): 1043-1051.
23. Michaud DS, Vrieling A, Jiao L, et al. Alcohol intake and pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium (PanScan). Cancer Causes Control, 2010, 21(8): 1213-1225.
24. Wang YT, Gou YW, Jin WW, et al. Association between alcohol intake and the risk of pancreatic cancer: a dose-response meta-analysis of cohort studies. BMC Cancer, 2016, 16: 212.
25. WCRFI. Pancreatic cancer statistics. World cancer research fund international. 2015. http://www.wcrf.org/int/cancer-facts-figures/data-specific-cancers/pancreatic-cancerstatistics.
26. Davoodi SH, Malek-Shahabi T, Malekshahi-Moghadam A, et al. Obesity as an important risk factor for certain types of cancer. Iran J Cancer Prev, 2013, 6(4): 186-194.
27. Maisonneuve P, Lowenfels AB. Risk factors for pancreatic cancer: a summary review of meta-analytical studies. Int J Epidemiol, 2015, 44(1): 186-198.
28. Paluszkiewicz P, Smolińska K, Dębińska I, et al. Main dietary compounds and pancreatic cancer risk. The quantitative analysis of case-control and cohort studies. Cancer Epidemiol, 2012, 36(1): 60-67.
29. Bao Y, Hu FB, Giovannucci EL, et al. Nut consumption and risk of pancreatic cancer in women. Br J Cancer, 2013, 109(11): 2911-2916.
30. Wu L, Wang Z, Zhu J, et al. Nut consumption and risk of cancer and type 2 diabetes: a systematic review and meta-analysis. Nutr Rev, 2015, 73(7): 409-425.
31. Appleby PN, Crowe FL, Bradbury KE, et al. Mortality in vegetarians and comparable nonvegetarians in the United Kingdom. Am J Clin Nutr, 2016, 103(1): 218-230.
32. Lightsey D, National Council Against Health Fraud and Quackwatch. Comment on ‘Red and processed meat consumption and risk of pancreatic cancer: meta-analysis of prospective studies’. Br J Cancer, 2012, 107(4): 754-755.
33. Beaney AJ, Banim PJR, Luben R, et al. Higher meat intake is positively associated with higher risk of developing pancreatic cancer in an age-dependent manner and are modified by plasma antioxidants: a prospective cohort study (EPIC-Norfolk) using data from food diaries. Pancreas, 2017, 46(5): 672-678.
34. Miller PE, Alexander D. A review and meta-analysis of prospective studies of red and processed meat and pancreatic cancer. FASEB J, 2016, 30: 902-909.
35. Yorifuji T, Tsuda T, Doi H, et al. Cancer excess after arsenic exposure from contaminated milk powder. Environ Health Prev Med, 2011, 16(3): 164-170.
36. Yorifuji T, Tsuda T, Grandjean P. Unusual cancer excess after neonatal arsenic exposure from contaminated milk powder. J Natl Cancer Inst, 2010, 102(5): 360-361.
37. Burney PG, Comstock GW, Morris JS. Serologic precursors of cancer: serum micronutrients and the subsequent risk of pancreatic cancer. Am J Clin Nutr, 1989, 49(5): 895-900.
38. Stevens RJ, Roddam AW, Beral V. Pancreatic cancer in type 1 and young-onset diabetes: systematic review and meta-analysis. Br J Cancer, 2007, 96(3): 507-509.
39. Huxley R, Ansary-Moghaddam A, Berrington de González A, et al. Type-Ⅱ diabetes and pancreatic cancer: a meta-analysis of 36 studies. Br J Cancer, 2005, 92(11): 2076-2083.
40. Li D, Tang H, Hassan MM, et al. Diabetes and risk of pancreatic cancer: a pooled analysis of three large case-control studies. Cancer Causes Control, 2011, 22(2): 189-197.
41. Bosetti C, Rosato V, Li D, et al. Diabetes, antidiabetic medications, and pancreatic cancer risk: an analysis from the International Pancreatic Cancer Case-Control Consortium. Ann Oncol, 2014, 25(10): 2065-2072.
42. Sharma A, Smyrk TC, Levy MJ, et al. Fasting blood glucose levels provide estimate of duration and progression of pancreatic cancer before diagnosis. Gastroenterology, 2018, 155(2): 490-500.
43. Grote VA, Rohrmann S, Nieters A, et al. Diabetes mellitus, glycated haemoglobin and C-peptide levels in relation to pancreatic cancer risk: a study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Diabetologia, 2011, 54(12): 3037-3046.
44. Midha S, Sreenivas V, Kabra M, et al. Genetically determined chronic pancreatitis but not alcoholic pancreatitis is a strong risk factor for pancreatic cancer. Pancreas, 2016, 45(10): 1478-1484.
45. Raimondi S, Lowenfels AB, Morselli-Labate AM, et al. Pancreatic cancer in chronic pancreatitis; aetiology, incidence, and early detection. Best Pract Res Clin Gastroenterol, 2010, 24(3): 349-358.
46. Fan X, Alekseyenko AV, Wu J, et al. Human oral microbiome and prospective risk for pancreatic cancer: a population-based nested case-control study. Gut, 2018, 67(1): 120-127.
47. Memba R, Duggan SN, Ni Chonchubhair HM, et al. The potential role of gut microbiota in pancreatic disease: a systematic review. Pancreatology, 2017, 17(6): 867-874.
48. Guo Y, Liu W, Wu J. Helicobacter pylori infection and pancreatic cancer risk: a meta-analysis. J Cancer Res Ther, 2016, 12(Supplement): C229-C232.
49. 曹成亮, 曲凤智, 王刚, 等. 幽门螺杆菌在胰腺癌发生发展中作用的研究进展. 中国普外基础与临床杂志, 2017, 24(10): 1275-1278.

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Epidemiology and risk factors of pancreatic cancer

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