title: The use of epidemiology, scientific data, and regulatory authority to determine risk factors in cancers of some organs of the digestive system. 6. Pancreatic cancer.
abstract: The etiology of pancreatic cancer remains elusive. It predominates in males and in certain ethnic populations (i.e., Polynesians and blacks). Primarily a disease of aging, it is rare in individuals under 40. Genetics is believed to play a very small part if any. While diabetics have higher than expected incidence and mortality rates, several recent studies have indicated that in most cases the diabetes is an early sign of pancreatic cancer rather than a predisposing condition. Other conditions have been infrequently reported in association with pancreatic cancer. None of them have shown a definitive associative pattern and are believed to represent coincidental occurrences. Migrant studies of Japanese immigrants implicate some type of environmental etiology, since pancreatic cancer rates increase dramatically within one to two generations. Studies on atom bomb survivors have demonstrated no link between a single intense dose of radiation and subsequent development of this disease. Workers exposed to low-level radiation have shown an increase in pancreatic cancer, but this result may reflect methodologic problems. Many chemicals have been shown to cause pancreatic cancer in animals, and chemists exhibit higher pancreatic cancer rates than expected. However, the human cases have not been traced to any specific chemical. Many other occupations besides chemistry have shown increased pancreatic cancer rates, but the common factor in these occupations is not obvious. Studies analyzing the relationship of alcohol consumption to pancreatic cancer yield conflicting results. This may be explained if the observed effects are due to a confounder, such as cigarette smoking; to an ingredient other than alcohol contained in alcoholic beverages, such as nitrosamines; or to the immunosuppressive effects of chronic excessive alcohol consumption. Smoking is the risk factor showing the most definitive and consistent results. There is little doubt that it plays an etiologic role, and it probably accounts for the higher incidence of the disease in males. Most other research does not support MacMahon's reported association between coffee drinking and pancreatic cancer. Recent studies have indicated a generally increased fluid intake in pancreatic cancer patients due to a disease-induced disturbance in glucose tolerance function. Such increased fluid intake would tend to manifest itself in the most popular beverage of the country (i.e., coffee in the United States and tea in the United Kingdom). Animal studies have indicated a link between pancreatic cancer and high fat and/or high protein diets as well as raw soybean consumption.(ABSTRACT TRUNCATED AT 400 WORDS)
mesh_terms: D000428:Alcohol Drinking; D002273:Carcinogens; D003069:Coffee; D048909:Diabetes Complications; D004032:Diet; D004067:Digestive System Neoplasms / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000209:etiology; D012067:Religion; D012306:Risk; D012907:Smoking; D014481:United States
chemical_list: D002273:Carcinogens; D003069:Coffee