Pancreatic cancer is the fourth leading cause of cancer death in the United States and the fifth leading cause of cancer death worldwide. Cancer of the pancreas accounts for only about 2% of the cancers diagnosed each year. However, the five-year survival rate is less than 5%, making pancreatic cancer a leading cause of cancer death.
The incidence of pancreatic cancer is 50 – 90% higher in African Americans than in any other racial group in the United States. Not only is pancreatic cancer more common among African Americans, but African Americans also have the poorest prognosis of any racial group because they often are diagnosed with advanced, and therefore, inoperable cancer. African Americans also are less likely to receive surgery than any other racial group in the United States.
Many studies have been conducted to determine why there is an increased risk of pancreatic cancer among African Americans. These studies suggest that environmental and socioeconomic factors may be important. Cigarette smoking, which causes about 25% of pancreatic cancer, is more common among African Americans and therefore may partially explain why pancreatic cancer is more common in African Americans. Other risk factors for pancreatic cancer that are more common in African Americans include diabetes mellitus, pancreatitis, and being overweight.
Environmental Risk Factors
Cigarette smoking is the most preventable cause of pancreatic cancer. Cigarette smoking accounts for 25-30% of pancreatic cancers. Smoking cigarettes doubles the risk of pancreatic cancer, regardless of race. Smoking rates among African American adults historically have been higher than among the general U.S. population. However, in recent years smoking rates for blacks and whites are similar.
Cigarette smoking is the most preventable cause of pancreatic cancer.
The risk of pancreatic cancer is elevated in diets high in fat and calories. Processed meat high in nitrates, such as bacon and bologna, also increase the risk. The human body may process nitrates into cancer causing chemicals, called carcinogens.
Body Mass Index
The risk of pancreatic cancer increases with body mass, regardless of racial group. However, it has been observed that obesity is more common among African American as compared to other racial groups. This may help to explain the increased incidence of pancreatic cancer among African Americans.
Low income is associated with an increased risk of pancreatic cancer for several reasons. First, individuals who earn lower incomes tend to smoke more and smoking doubles the risk of pancreatic cancer. Also, people who earn low incomes are less likely to receive proper nutrition and healthcare. According to the U.S. Census Bureau, African Americans accounted for about one quarter of the U.S. population in poverty in 2001.
Blacks are nearly twice as likely as whites to have diabetes mellitus (sugar diabetes). There are two types of diabetes, Type I and Type II. Type I diabetes, sometimes called juvenile diabetes, generally affects younger individuals and is caused by damage to the pancreatic cells that secrete insulin. Individuals with Type I usually become insulin dependent. Type I diabetes has not been linked to pancreatic cancer. However, Type II diabetes, which tends to occur in adults, has been shown to double the risk of pancreatic cancer. Type II diabetes is associated with obesity and lack of exercise. Diabetes can sometimes be caused by pancreatic cancer.
Pancreatitis is an inflammatory disease of the pancreas. Pancreatitis may either be acute (sudden and severe) or chronic (long-standing). Individuals that have had repeated attacks of acute pancreatitis can develop chronic pancreatitis.
The risk of pancreatic cancer is elevated in all patients with pancreatitis and African Americans are at the highest risk of developing pancreatitis of any racial group.
African Americans are twice as likely as white Americans to have diabetes mellitus. Type II diabetes doubles the risk of pancreatic cancer.
The overall risk of pancreatic cancer due to “genes” is thought to be the same for most racial groups. It is believed that 5-10% of patients develop pancreatic cancer because of an inherited factor. More information on the genetic basis of pancreatic cancer.
The best way to reduce your risk of pancreatic cancer is to:
- quit smoking if you smoke,
- eat a diet high in fruits and vegetables and low in processed meats, and
- lose weight if you are heavy.
What can you do to help the fight against pancreatic cancer?
If you or a member of your family has been diagnosed with pancreatic cancer you can help us study this disease by participating in research studies. The National Familial Pancreas Tumor Registry at Johns Hopkins is a research study working to discover risk factors for pancreatic cancer as well as ways to detect pancreatic cancer at an early, curable stage.