Environmental risk factors for pancreatic cancer: an update

Our plain-English summary of Environmental risk factors for pancreatic cancer: an update, by E. Barone, A. Corrado, F. Gemignani, et al (Archives of Toxicology, 2016).

The study

• Authors: E. Barone, A. Corrado, F. Gemignani, S. Landi
• Journal: Archives of Toxicology
• Published: 2016;90(11):2617-2642
• Type of article: Review
• Cited by: 71 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

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.

In plain English

This article was a review, not a new study. The authors described published case–control studies, meta-analyses and cohort studies, found through PubMed, on non-genetic factors suspected of raising the risk of pancreatic cancer. These included smoking, alcohol, diet, drugs, infections, medical conditions and workplace exposures. They called cigarette smoke the best-documented risk factor. On asbestos, the review cited two studies by other researchers. One (Santibañez and colleagues, 2010) reported an odds ratio of 7.54 (95% confidence interval 1.61 to 35.19) among males. The other (Antwi and colleagues, 2015) reported an odds ratio of 1.54 (95% confidence interval 1.23 to 1.92) for people regularly exposed to asbestos. The review did not name asbestos fiber types. It also cited higher pancreatic cancer death rates linked to silica in German porcelain and fine ceramic workers. The authors concluded that the evidence was still not conclusive but highly suggestive of a role for asbestos and silica fibers. They also proposed, as their own view, that the build-up of asbestos fibers may play a role in the progression of the disease.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: narrative review of published case–control studies, meta-analyses and cohort studies
• Who was studied: Published studies on pancreatic cancer risk factors retrieved from PubMed; the number of studies reviewed is not stated
• Exposure: Many non-genetic factors, including occupational exposure to inorganic particles such as asbestos and vitreous or silica fibers; asbestos fiber types are not specified
• Main results:
  • Cited study (Santibañez et al. 2010): odds ratio of 7.54 (95% CI 1.61 to 35.19) for pancreatic cancer among males exposed to asbestos
  • Cited study (Antwi et al. 2015): odds ratio of 1.54 (95% CI 1.23 to 1.92; p = 0.0001) for people regularly exposed to asbestos
  • Cited study (Birk et al. 2009): silica fibers were associated with increased pancreatic cancer mortality in German porcelain and fine ceramic workers (standardized mortality ratio 1.71; 95% CI 1.18 to 2.41)
  • The authors described cigarette smoke exposure as the best-documented risk factor for pancreatic cancer
• The authors' conclusion: The authors concluded that the evidence was still not conclusive but highly suggestive of a role for asbestos and silica fiber exposure in pancreatic cancer. They proposed that the accumulation of asbestos fibers seems to play a role in the progression of the disease.

Topics

Medical terms in this study, explained in our Lexicon: Acinar, Habit.

Related studies

• Exposure to environmental chemicals and heavy metals, and risk of pancreatic cancer — S.O. Antwi, E.C. Eckert, et al. (2015)
• Pancreatic cancer and occupational exposures — T. Kauppinen, T. Partanen, et al. (1995)
• Occupational exposure to dyes, metals, polycyclic aromatic hydrocarbons and other agents and K-ras activation in human exocrine pancreatic cancer — J. Alguacil, M. Porta, et al. (2003)
• Association of diabetes susceptibility gene calpain-10 with pancreatic cancer among smokers — P.Y. Fong, M.D. Fesinmeyer, et al. (2010)
• Occupational exposures and pancreatic cancer: a meta-analysis — I.A. Ojajärvi, T.J. Partanen, et al. (2000)
• Assessment of "gene-environment" interaction in cases of familial and sporadic pancreatic cancer — T.P. Yeo, R.H. Hruban, et al. (2009)

Browse more research in Archives of Toxicology, or return to medical research.