Understanding your risk for pancreatic cancer

In 2021 alone, an estimated 60,430 Americans will be diagnosed with pancreatic cancer in the U.S., and nearly all will die from the disease. A pancreatic cancer diagnosis can bring a heightened level of anxiety as typically patients do not present with overt symptoms until the disease has progressed. With that said, it may be helpful for people to understand the risk factors for this disease.

Sherise Rogers, M.D., is an assistant professor in the UF College of Medicine and an oncologist who specializes in treating pancreatic cancer.

“Knowing your family history will help you understand your individual risk for not only pancreatic cancer, but many types of cancer as it may be due to a hereditary cancer syndrome,” Rogers said.

Hereditary cancer syndromes are caused by specific gene mutations that can be passed down from our parents. These gene mutations may be associated with not only pancreatic cancer but many other cancers. A doctor or genetic counselor can order blood testing to look for these gene mutations.

Examples of some hereditary cancer syndromes that are associated with pancreas cancer are as follows:

• Hereditary Breast and Ovarian Cancer Syndrome, caused by mutations in the BRCA1 or BRCA2 genes
• Hereditary breast cancer, caused by mutations in the PALB2 gene
• Familial atypical multiple mole melanoma (FAMMM) syndrome, caused by mutations in the p16/CDKN2A gene and associated with skin and eye melanomas
• Familial pancreatitis, caused by mutations in the PRSS1 gene
• Lynch syndrome, also known as hereditary non-polyposis colorectal cancer (HNPCC), most often caused by a defect in the MLH1 or MSH2 genes Peutz-Jeghers syndrome

Only 15% of patients with pancreatic cancer actually have a hereditary cancer syndrome. This means that the majority of pancreatic cancer cases are not associated with a known gene that researchers have found thus far. If you have two or more members of your family who are first-degree relatives with pancreatic cancer, you may be at risk for familial pancreatic cancer, which accounts for another 10% of new cases.

The rate of pancreatic cancer increases with age, with 70% of cases in people older than 65. However, it can be diagnosed at any adult age. Men have higher rates of pancreatic cancer than women. Black patients are diagnosed at higher rates than white patients. Chronic pancreatitis, pancreatic cysts, H. pylori infection, hepatitis viruses, cystic fibrosis and some individuals with newly diagnosed diabetes are at higher risk for pancreatic cancer.

Cigarette smoking is strongly linked to many cancers, including pancreatic cancer. Chemical and heavy metal exposure is also associated with this diagnosis. Gum disease also increases one’s risk. There are steps you can take to reduce the likelihood of developing pancreatic cancer: avoid foods high in saturated fats, stop smoking, maintain a healthy weight, increase physical activity, avoid heavy alcohol use and get regular dental check-ups and cleanings.

One of the most common difficulties associated with pancreatic cancer is that many patients do not notice symptoms early on. It is imperative that patients stay alert for signs to receive an earlier diagnosis and treatment. The most common symptoms of pancreatic cancer are:

• Jaundice
• Abdominal pain
• Weight loss and poor appetite
• Nausea and vomiting
• New blood clot development
• New or onset diabetes

If you believe you are of higher risk or have concerning symptoms, please speak to your primary care physician about whether you should have screening for pancreatic cancer and/or testing for genetic hereditary syndromes.