Aetiology

Incidence of pancreatic cancer

Pancreatic cancer is a common condition in the United Kingdom and, as people have started to live longer over the last 80 years, the numbers diagnosed have doubled. Some 6500 cases are registered annually and in British men pancreatic cancer was surpassed as a cause of death only by lung cancer, colorectal cancer, prostate and bladder cancer and gastric cancer. The increase in the incidence of pancreatic cancer may reflect earlier under-reporting and mistaken diagnosis. The disease is uncommon before the age of 45 but it increases steadily after that age.

Aetiology of pancreatic cancer

The risk factors include cigarette smoking, diet with the consumption of a western diet (relatively high fat and meat intake) has also been implicated. Although the possibility of a link between coffee consumption and pancreatic cancer cannot be disregarded, the available data does not prove a causal association as yet. In the case of tea drinking, the overwhelming majority of studies have failed to show any association with pancreatic cancer. Available data does not show any consistent relationship between alcohol consumption and the risks of developing pancreatic cancer.

The development of diabetes mellitus cannot be regarded as a proven risk factor in the development of pancreatic cancer. However, the development of diabetes in later years should however raise the index of suspicion towards an occult or overt pancreatic tumour. There may be an association between pernicious anaemia and the development of pancreatic cancer but more work is required in this field. Chronic pancreatitis has been thought to increase the incidence of pancreatic cancer but once again the data are inconclusive.

Pancreatic cancer is a malignancy known to occur in cancer family syndromes. Familial chronic pancreatitis and inherited diabetes mellitus, may predispose to the development of pancreatic cancer.