Pancreatic cancer risk factors: who is at higher risk and what to watch for

Why risk factors matter for this cancer

Pancreatic cancer usually has no early signs or symptoms, which makes it very hard to find early. Symptoms usually begin after the cancer has spread (NCI symptoms). Because the pancreas sits behind other organs, providers cannot see or feel a tumor during a routine exam (MedlinePlus).

Pancreatic cancer is uncommon, at about 12.9 cases per 100,000 people a year, but it is the third most common cause of cancer death in the US (USPSTF 2019).

Risk factors

A risk factor raises the chance of getting a disease. Having one or more does not mean you will get pancreatic cancer: many people with risk factors never get it, and some people with no known risk factors do (NCI risk factors).

• Smoking. The NCI calls smoking a major risk factor. Chemicals in tobacco smoke can damage DNA in pancreatic cells (NCI risk factors) (MedlinePlus).
• Older age. Risk rises with age. Nearly two-thirds of people are diagnosed at 65 or older, but younger people can get it too (NCI risk factors).
• Family history. A parent or sibling, or several second-degree relatives (such as grandparents, aunts or cousins), with pancreatic cancer or pancreatitis may raise your risk (NCI risk factors).
• Inherited gene changes. Up to 10% of pancreatic cancers are linked to inherited genetic syndromes (NCI risk factors). The NCI lists:
  • hereditary breast and ovarian cancer syndrome (BRCA1 and BRCA2 genes)
  • hereditary breast cancer linked to the PALB2 gene
  • Lynch syndrome (MLH1, MSH2, MSH6 or PMS2 genes)
  • FAMMM syndrome (CDKN2A gene)
  • ataxia-telangiectasia (ATM gene)
  • hereditary pancreatitis (PRSS1 gene)
  • Peutz-Jeghers syndrome (STK11 gene)
  • Li-Fraumeni syndrome (TP53 gene) (NCI risk factors)
• Diabetes. Diabetes can raise the risk; MedlinePlus names long-term diabetes. A new diagnosis of diabetes can also be a symptom of pancreatic cancer (NCI risk factors) (MedlinePlus).
• Chronic pancreatitis. Long-term inflammation of the pancreas can damage its tissue and raise the risk (NCI risk factors) (MedlinePlus).
• Obesity. Excess body weight (a BMI of 30 or higher) is linked to a higher risk (NCI risk factors).
• Possible risk factors. Heavy drinking may raise the risk, partly because it can lead to chronic pancreatitis. Some chemicals used in dry cleaning and metalworking may be linked too, but more research is needed (NCI risk factors).

Symptoms to report

As the cancer grows, signs can include (NCI symptoms):

• pain in the upper or middle belly and the back
• jaundice: yellow skin and whites of the eyes, light-colored stools, dark urine, itching
• weight loss for no known reason, loss of appetite and tiredness
• gas or bloating, nausea and vomiting
• swelling in the legs

The NCI also names new-onset diabetes in someone with no risk factors for diabetes, and a new blood clot together with other symptoms, as possible signs worth discussing with a doctor (NCI symptoms). These symptoms can also come from other, less serious conditions (NCI symptoms).

Screening: average risk vs high risk

Screening for people at high risk uses imaging such as CT scans, endoscopic ultrasound or MRI. Its possible harms include false-positive results, overdiagnosis and false-negative results (NCI screening). The pancreatic cancer screening check walks through the USPSTF statement.

Can pancreatic cancer be prevented?

The NCI says nothing can prevent pancreatic cancer, but quitting smoking, limiting alcohol and keeping a healthy weight and diet can help lower the risk of it and of other cancers (NCI risk factors). The quit smoking help check covers what works for quitting.

Related checks

If breast, ovarian or other cancers run in your family, the BRCA risk assessment shows whether the USPSTF advises genetic counseling. Since diabetes raises the risk (NCI risk factors), the diabetes risk test can show whether you should be tested for type 2 diabetes.

Common questions

A parent had pancreatic cancer. Should I be screened?

A parent or sibling with pancreatic cancer may raise your risk (NCI risk factors). The NCI advises genetic counseling and screening for people with two or more close relatives with it (NCI screening). Ask your doctor whether genetic counseling fits your family history.

I have type 2 diabetes. Does that mean I will get pancreatic cancer?

No. Many people with diabetes never get pancreatic cancer (NCI symptoms). Diabetes raises the risk, and people with it but no symptoms are still covered by the USPSTF recommendation against screening (NCI risk factors) (USPSTF 2019).

Is there a blood test for pancreatic cancer?

There are no standard screening tests for pancreatic cancer (NCI screening). Doctors diagnose it with a physical exam, blood tests, imaging tests and a biopsy (MedlinePlus).