Diabetes and pancreatic cancer

Pancreatic cancer is a highly malignant tumor of the digestive tract that is difficult to diagnose and treat early. About 90% of cases are ductal adenocarcinoma, originating in the ductal epithelium. The 5-year survival rate is less than 1%, making it one of the worst-prognosis cancers. The disease is more common in males than females, with a male to female ratio of 1.5–2:1, though postmenopausal women have a similar incidence to men. Early diagnosis rates remain low, surgical mortality is high, and the cure rate is very low.

Several lifestyle factors are known to increase the risk of pancreatic cancer, and addressing them proactively is one of the most effective forms of prevention. Smoking is the most well-established risk factor — smokers are 1.6 to 3.1 times more likely to develop pancreatic cancer than non-smokers. Heavy alcohol consumption and untreated chronic pancreatitis or biliary tract disease also raise risk significantly.

Diet plays an important role as well. Reducing intake of red meat, high-fat, and high-calorie foods while eating more vegetables, fruits, and coarse grains can prevent an estimated 33–50% of pancreatic cancer cases. Broccoli and cruciferous vegetables in particular contain isothiocyanates, which help prevent DNA damage. Regular moderate exercise and green tea consumption also contribute to reducing cancer risk through antioxidant and anti-tumor effects.

1. Age over 40 years old, with non-specific upper abdominal discomfort.

2. A family history of pancreatic cancer.

3. Sudden diabetes, especially atypical diabetes, over 60 years old, lack of family history, no obesity, and quickly develop insulin resistance. 40% of pancreatic cancer patients are diagnosed with diabetes.

4. Chronic pancreatitis patients. Currently, chronic pancreatitis is an important precancerous lesion in a small number of patients, especially chronic familial pancreatitis and chronic calcifying pancreatitis.

5. Intraductal papillary myxoma is also a precancerous lesion.

6. Those with familial adenomatous polyposis.

7. Those who underwent distal gastrectomy for benign lesions, especially those who are more than 20 years after surgery.

8. Long-term smoking, heavy drinking, and long-term exposure to harmful chemicals. The risk factors for pancreatic cancer are complex, with endogenous (family history, genetic mutation) and exogenous (environment, diet and other factors). A study published in the journal Nature in 2010 pointed out that normal pancreatic ductal epithelial cells gradually evolve into cancer. It takes 9 years from genetic mutation to the formation of a real tumor cell, 8 years from the development of a tumor cell to a cell mass with metastatic ability, and the death from tumor discovery to tumor is less than 2 years. Therefore, the adverse factors that cause cell malignancy should be avoided as much as possible to prevent the occurrence of pancreatic cancer.

1. Smoking: It is currently recognized as a high-risk factor for pancreatic cancer. Studies have shown that the risk ratio of smoking pancreatic cancer patients to non-smokers is 1.6-3.1: 1. Studies have shown that carcinogens in tobacco leaves can cause cancer of the pancreatic duct epithelium.

2. Unhealthy diet: The World Cancer Research Foundation and the American Cancer Institute summarized the relationship between diet and pancreatic cancer. It is believed that foods rich in red meat (pig, beef, lamb), high fat and high energy may increase the risk of pancreatic cancer, and the intake of a diet rich in vegetables and fruits can prevent 33% to 50% of pancreatic cancer Morbidity.

3. Genetic factors: The incidence of pancreatic cancer is 3-13 times that of people with a family history compared to those without a family history. It is reported that one person in the family has the disease, and the risk of pancreatic cancer among other family members is 4 times that of the general population If 2 people get sick, it will increase to 12 times, and 3 people get up to 40 times. Some researchers have come across multiple pancreatic cancer families of mother and daughter, father and son, siblings, and grandchildren.

4. Chronic lesions of the pancreas: Recurrent episodes of chronic pancreatitis, pancreatic duct stones or calculous pancreatitis have a tendency to become cancerous, and can be considered as a precancerous lesion. Attention should be paid to the treatment of primary disease and follow-up should be carried out closely. The onset is also related to the human body’s own diseases, such as chronic pancreatic diseases and oral diseases.

5. Diabetes: The study found that diabetic patients are twice as likely to have pancreatic cancer as the normal population. The incidence of diabetes in pancreatic cancer patients is almost twice that of the normal population. Therefore, patients without a family history of diabetes suddenly find that they must be carefully checked to rule out pancreatic cancer.

6. Benign pancreatic tumor: Like other organs, the pancreas also has many benign tumors. For example: serous or mucinous cystadenoma, solid pseudopapillary tumor, intraductal mucinous papilloma, etc., which can also be transformed into pancreatic cancer, especially mucinous papilloma and intraductal mucinous papilloma.

7. Oral diseases: Studies have shown that dental caries and other oral inflammatory diseases can also increase the incidence of pancreatic cancer.

8. Others: Patients with familial adenomatous polyposis, benign lesions undergoing distal gastrectomy, biliary tract disease, gallbladder surgical resection, and Helicobacter pylori positive will also increase the risk of pancreatic cancer.