Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes

Table 1 Summary of modifiable risk factors associated with pancreatic cancer

Factor	Direction of association	Strength of association	Type of studies conducted	Related notable findings	Ref.
Smoking	Positive	Strong association; 74% increased risk in current smokers; 20% increased risk in former smokers	Case-control, cohort, nested case-control studies	Dose responsive; risk remains 10-20 yr following smoking cessation	[18-20]
Alcohol	Mixed between no association and positive	Various; 15%-43% increased risk in meta-analysis	Meta-analysis of cohort studies	Dose responsive; sex dependent; Increased risk in spirit drinkers; link with chronic pancreatitis which is a risk factor for pancreatic cancer	[9,21-24]
Obesity	Positive	10% increased risk for every 5 BMI units	Cohort studies	Link with Type 2 diabetes which is associated with increased risk of pancreatic cancer	[25]
Dietary factors	Variable	Non-significant positive association for red meat; 17% increased risk associated with 50 g/d of processed meat consumption compared to 20 g/d	Cohort studies	Overall consensus cannot be made and further research is required	[25]
Helicobacter pylori	Positive	45% increased risk	Meta-analysis of case-control studies	Significant publication bias and small numbers included therefore further studies are required	[26]

BMI: Body mass index.