title: Environmental risk factors for pancreatic cancer: an update.
abstract: Pancreatic cancer (PC) is one of the most aggressive diseases. Only 10 % of all PC cases are thought to be due to genetic factors. Here, we analyzed the most recently published case-control association studies, meta-analyses, and cohort studies with the aim to summarize the main environmental factors that could have a role in PC. Among the most dangerous agents involved in the initiation phase, there are the inhalation of cigarette smoke, and the exposure to mutagenic nitrosamines, organ-chlorinated compounds, heavy metals, and ionizing radiations. Moreover, pancreatitis, high doses of alcohol drinking, the body microbial infections, obesity, diabetes, gallstones and/or cholecystectomy, and the accumulation of asbestos fibers seem to play a crucial role in the progression of the disease. However, some of these agents act both as initiators and promoters in pancreatic acinar cells. Protective agents include dietary flavonoids, marine omega-3, vitamin D, fruit, vegetables, and the habit of regular physical activity. The identification of the factors involved in PC initiation and progression could be of help in establishing novel therapeutic approaches by targeting the molecular signaling pathways responsive to these stimuli. Moreover, the identification of these factors could facilitate the development of strategies for an early diagnosis or measures of risk reduction for high-risk people.
authors.affiliation: Genetic Unit, Department of Biology, University of Pisa, Via Derna, 1, 56121, Pisa, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Barone
authors.affiliation: Genetic Unit, Department of Biology, University of Pisa, Via Derna, 1, 56121, Pisa, Italy.
authors.forename: Alda
authors.initials: A
authors.lastname: Corrado
authors.affiliation: Genetic Unit, Department of Biology, University of Pisa, Via Derna, 1, 56121, Pisa, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Gemignani
authors.affiliation: Genetic Unit, Department of Biology, University of Pisa, Via Derna, 1, 56121, Pisa, Italy. stefano.landi@unipi.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Landi
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects; D000818:Animals; D002274:Carcinogens, Environmental / Q000633:toxicity; D015986:Confounding Factors, Epidemiologic; D000072001:Diet, Healthy; D066273:Diet, Western / Q000009:adverse effects; D018450:Disease Progression; D004198:Disease Susceptibility; D019317:Evidence-Based Medicine; D000070497:Healthy Lifestyle; D006801:Humans; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D010179:Pancreas / Q000187:drug effects / Q000503:physiopathology / Q000528:radiation effects; D010190:Pancreatic Neoplasms / Q000139:chemically induced / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D011839:Radiation, Ionizing; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
chemical_list: D002274:Carcinogens, Environmental
keywords: Environmental factors; Pancreas; Pancreatic cancer; Protective factors; Risk factors