J 2021

Risk factors of pancreatic cancer and their possible uses in diagnostics

LANG, Jitka, Lumír KUNOVSKÝ, Zdeněk KALA and Jan TRNA

Basic information

Original name

Risk factors of pancreatic cancer and their possible uses in diagnostics

Authors

LANG, Jitka (203 Czech Republic), Lumír KUNOVSKÝ (203 Czech Republic, belonging to the institution), Zdeněk KALA (203 Czech Republic, belonging to the institution) and Jan TRNA (203 Czech Republic, guarantor, belonging to the institution)

Edition

Neoplasma, Bratislava, Aeapress, 2021, 0028-2685

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30204 Oncology

Country of publisher

Slovakia

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.409

RIV identification code

RIV/00216224:14110/21:00120991

Organization unit

Faculty of Medicine

DOI

UT WoS

000814594100001

Keywords in English

pancreatic cancer; pancreatic ductal adenocarcinoma; risk factors; chronic pancreatitis; PanIN lesions; mucinous cystic neoplasm; diabetes mellitus; smoking

Tags

Tags

International impact, Reviewed
Změněno: 9/8/2023 12:32, Mgr. Tereza Miškechová

Abstract

V originále

Pancreatic cancer (PC) is a form of malignancy of increasing incidence and poor prognosis, with an average of less than 10% of patients surviving 5 years after being diagnosed. The main reason for this unfavorable situation is the long asymptomatic course of the disease, and the absence of a simple screening method, typically leading to the late discovery of the disease. The development of the malignancy from the initial carcinogenesis into invasive pancreatic carcinoma takes approximately 10 years. However, the progression of pancreatic cancer from early into advanced stages can be, according to the latest studies, incredibly fast, just a few months. Early stages of pancreatic malignancy can be detected only by expensive, and sometimes invasive, diagnostic methods (CT, MR/MRCP, or EUS). Due to the current absence of a reliable non-invasive screening method, it is necessary to define a group of patients who have the highest risk of PC development, five to ten times higher risk compared to the regular population at a minimum. Risk factors combine in their effect; therefore, relative risks of PC development need to be summarized to obtain a total relative risk for each person. The main and non-influenceable risk factor in the development of PC is the increasing age. The other non-influenceable risk factor of PC is a genetic predisposition - family incidence of the disease can be detected in 4-16% of patients. Some specific genes and mutations which can play a role in PC development have already been identified (for example mutation of the PRSS-1 gene). Among the influenceable risk factors of PC is primarily smoking; obesity can play a part in PC development as well. A higher risk of PC is observed in patients with chronic pancreatitis. Nowadays, the relationship between PC and diabetes mellitus (DM) is hotly discussed. In the case of long-standing DM, the risk of pancreatic cancer is two times higher compared to the healthy population. However, new-onset DM can be the first sign of still asymptomatic PC. These patients, with paraneoplastic DM caused by pancreatic cancer cells, represent approximately 1% of recently diagnosed patients. However, this group of patients is still too large for screening. Because of that, it is necessary to find specific criteria to distinguish classic DM from the paraneoplastic form. The application of these criteria can help with the better stratification of risk in patients with new-onset diabetes and hence, it can help to discover PC in its early stages.