Risk Factors in Pancreatic Adenocarcinoma: the Interrelation with Familial History and Predictive Role on Survival

Abstract

Background and Aims: Pancreatic cancer is associated with poor survival and quality of life. In Romania the prognostic influence of known risk factors for pancreatic adenocarcinoma, such as age, smoking, chronic pancreatitis, diabetes mellitus, and obesity is little known. Their importance in developing cancer in families with a history of adenocarcinoma is less studied. This study aims to assess the risk factors in pancreatic ductal adenocarcinoma, in familial pancreatic adenocarcinoma, in neuroendocrine tumors and to evaluate their predictive role on survival.
 Methods: We performed a prospective bicentric study of patients with pancreatic tumors detected in transabdominal imaging; we assessed the risk factors and their possible association with survival.
 Results: 312 pancreatic cancer patients (279 with pancreatic ductal adenocarcinoma and 24 patients with neuroendocrine tumors, and nine patients with other malignant types) and 312 controls were included. The median body mass index was significantly higher in patients with neuroendocrine tumors. Positive family history for pancreatic cancer was found in 4% of patients with pancreatic cancer. The risk for familial pancreatic carcinoma was associated with the presence of new-onset diabetes (OR: 4.64, p=0.018). The multivariate logistic analysis suggested that advanced age (OR: 1.67), smoking (OR: 1.67), low body mass index (OR: 12.07), and diabetes (OR: 3.91) were risk factors for pancreatic cancer. The overall survival analysis after adjustment for age and tumor stage showed only advanced tumoral stage (HR=1.6, p=0.003) and metastasis as independent predicting factors (HR=1.67, p<0.001).
 Conclusion: Our study suggests that diabetes, smoking, underweight, and age over 60 years are risk factors for pancreatic cancer. Patients with a family history of pancreatic cancer, especially those with new-onset diabetes, should be followed carefully and considered for screening. Only an advanced tumor stage was associated with poor overall survival for patients with pancreatic ductal adenocarcinoma.

The incidence and clinical features of familial pancreatic cancer in Korea

“…Similar to our study results, Tezuka et al 24 reported that the mean age of FPC was higher than that of non‐FPC, but there was no age difference between FPC and non‐FPC in other studies 15,20,22,23,25,26 . The mean age of FPC patients who underwent curative‐intent operation was 75.3 years, which was higher than the results of other previous studies 15,20‐26 (Table 5). In our study, the mean age of FPC patients who underwent curative‐intent operation was significantly higher than the mean age of FPC patients who did not (75.3 ± 4.8 years vs 60.1 ± 11.4 years, P = .002).…”

“…The incidence of FPC for all PC patients was lower than 3.5%-8.9% in previous studies. 15,[20][21][22][23] Also the incidence of FPC for PC patients who underwent curative-intent operation was much lower than in previous studies-6.4%-7.3% [24][25][26] (Table 5). However, our results were similar to the prevalence of FPC (2.7%, 34 parents affected by PC among 1254 PC patients) identified in a large national epidemiological study based on the Sweden Cancer Registry conducted by Hemminki and Li.…”

“…In this study, the incidence of FPC was 3.1% in all PC patients who underwent surgical or medical treatment and 1.8% of PC patients who underwent curative‐intent surgery. The incidence of FPC for all PC patients was lower than 3.5%‐8.9% in previous studies 15,20‐23 . Also the incidence of FPC for PC patients who underwent curative‐intent operation was much lower than in previous studies—6.4%‐7.3% 24‐26 (Table 5).…”

Type 2 Diabetes Mellitus Intersects With Pancreatic Cancer Diagnosis and Development

“…However, universal screening of PC in all elderly patients with NOD is difficult to achieve and not cost effective. In recent years, many studies have proposed different strategies to stratify T2DM groups and facilitate targeted screening (71)(72)(73)(74).…”

Cytotoxic and Proapoptotic Effects of Resveratrol in In Vitro Studies on Selected Types of Gastrointestinal Cancers

“…Pancreatic cancer is the ninth most common cancer in women and the tenth most common cancer in men [ 49 , 50 ]. The highest number of cases is recorded among the elderly [ 51 , 52 ]. Pancreatic cancer is difficult to diagnose due to the lack of characteristic symptoms [ 53 ].…”