Pancreatic cancer primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Sudarshana Datta, MD [2]

## Overview

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Primary prevention of pancreatic cancer involves the cessation of cigarette smoking, regular exercise and a healthy diet as per the American Cancer Society (ACS) guidelines. Cigarette smoking is considered to be the most significant modifiable risk factor for the development of pancreatic cancer. The risk of developing pancreatic cancer becomes almost equivalent to that of a nonsmoker after five years of smoking cessation. The American Cancer Society (ACS) has issued guidelines for diet and physical activity at both individual and community levels and advocates the intake of plenty of vegetables and fruits, protein from fowl and plant sources like whole grains and consumption of tuna, mackerel or salmon that are major sources of protein and long-chain omega-3 fatty acids.

## Primary Prevention

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Prevention of pancreatic cancer involves avoiding the following risk factors:[1]

#### Cessation of cigarette smoking:

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* Cigarette smoking is considered to be the most significant modifiable risk factor.
* Smoking accounts for the incidence of pancreatic cancer in one-fourth of all cases.[2][3]
* Nicotine in cigarettes stimulates tumorigenesis, increasing metastasis and resistance to treatment, hence impacting survival in patients.[4]
* The risk of pancreatic cancer significantly falls with cessation of cigarette smoking.[2][5][6][7][8][9][10][11]
* The risk of developing pancreatic cancer becomes almost equivalent to that of a nonsmoker after five years of cessation.[5][7][11][12]

#### Regular exercise and healthy diet:

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* Obesity is considered as a potential risk factor for pancreatic cancer.[13][14][15]
* Regular exercise decreases the risk of pancreatic cancer as compared to individuals having a sedentary lifestyle.[7][16]
* The American Cancer Society (ACS) has issued guidelines for diet and physical activity at both individual and community levels.[17][18][19]
* Diet:
* A healthy balanced diet doesn't exceed 2000 calories daily and includes the following:[8][10][11][20][21][22][23][24][25][26][27][28]
* Plenty of vegetables and fruits: blueberries, spinach, broccoli, tomatoes
* Lean meat from fowl, fish and plant sources like nuts or whole grains
* Monounsaturated fats help control insulin levels in type 2 diabetics
* Tuna, mackerel, salmon, and sardine are major sources of long-chain omega-3 fatty acids due to anticancer properties
* Food rich in B12, B6, Vitamin D and folate
* A poor diet includes the presence of the following:[5][13][20][29][30]
* Food preservatives and additives
* Smoked meat
* Heavy alcohol use
* High cholesterol
* Red meat
* Low consumption of fruits and vegetables
* Saturated fatty acids
* Processed foods
* High-fat, high-protein diet
* Chemicals known as heterocyclic amines, nitrates, and heme iron, found in foods, cause DNA damage and are carcinogenic

#### Slowing down the ageing process:

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* Ageing is associated with the development of pancreatic cancer.[12]
* Regular exercise and a healthy diet slows down the ageing process and decreases the risk of developing pancreatic cancer.[7]

## References

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1. ↑ http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_Can_pancreatic_cancer_be_prevented_34.asp?rnav=cri
2. ↑ 2.0 2.1 Bochatay L, Girardin M, Bichard P, Frossard JL (2014). "[Pancreatic cancer in 2014: screening and epidemiology]". Rev Med Suisse (in French). 10 (440): 1582–5. PMID 25276995.CS1 maint: Unrecognized language (link)
3. ↑ Qiu D, Kurosawa M, Lin Y, Inaba Y, Matsuba T, Kikuchi S, Yagyu K, Motohashi Y, Tamakoshi A (2005). "Overview of the epidemiology of pancreatic cancer focusing on the JACC Study". J Epidemiol. 15 Suppl 2: S157–67. PMID 16127228.
4. ↑ Toki MI, Syrigos KN, Saif MW (2014). "Risk determination for pancreatic cancer". JOP. 15 (4): 289–91. PMID 25076322.
5. ↑ 5.0 5.1 5.2 Lowenfels AB, Maisonneuve P (2006). "Epidemiology and risk factors for pancreatic cancer". Best Pract Res Clin Gastroenterol. 20 (2): 197–209. doi:10.1016/j.bpg.2005.10.001. PMID 16549324.
6. ↑ Bosetti C, Bertuccio P, Malvezzi M, Levi F, Chatenoud L, Negri E, La Vecchia C (2013). "Cancer mortality in Europe, 2005-2009, and an overview of trends since 1980". Ann. Oncol. 24 (10): 2657–71. doi:10.1093/annonc/mdt301. PMID 23921790.
7. ↑ 7.0 7.1 7.2 7.3 Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P (2012). "Pancreatic cancer: overview of descriptive epidemiology". Mol. Carcinog. 51 (1): 3–13. doi:10.1002/mc.20785. PMID 22162227.
8. ↑ 8.0 8.1 Hart AR (1999). "Pancreatic cancer: any prospects for prevention?". Postgrad Med J. 75 (887): 521–6. PMC 1741344. PMID 10616684.
9. ↑ Vimalachandran D, Ghaneh P, Costello E, Neoptolemos JP (2004). "Genetics and prevention of pancreatic cancer". Cancer Control. 11 (1): 6–14. PMID 14749618.
10. ↑ 10.0 10.1 Ghadirian P, Lynch HT, Krewski D (2003). "Epidemiology of pancreatic cancer: an overview". Cancer Detect. Prev. 27 (2): 87–93. PMID 12670518.
11. ↑ 11.0 11.1 11.2 Landi S (2009). "Genetic predisposition and environmental risk factors to pancreatic cancer: A review of the literature". Mutat. Res. 681 (2–3): 299–307. doi:10.1016/j.mrrev.2008.12.001. PMID 19150414.
12. ↑ 12.0 12.1 Li D, Xie K, Wolff R, Abbruzzese JL (2004). "Pancreatic cancer". Lancet. 363 (9414): 1049–57. doi:10.1016/S0140-6736(04)15841-8. PMID 15051286.
13. ↑ 13.0 13.1 Bracci PM (2012). "Obesity and pancreatic cancer: overview of epidemiologic evidence and biologic mechanisms". Mol. Carcinog. 51 (1): 53–63. doi:10.1002/mc.20778. PMC 3348117. PMID 22162231.
14. ↑ Carreras-Torres R, Johansson M, Gaborieau V, Haycock PC, Wade KH, Relton CL, Martin RM, Davey Smith G, Brennan P (2017). "The Role of Obesity, Type 2 Diabetes, and Metabolic Factors in Pancreatic Cancer: A Mendelian Randomization Study". J. Natl. Cancer Inst. 109 (9). doi:10.1093/jnci/djx012. PMID 28954281.
15. ↑ Eibl G, Cruz-Monserrate Z, Korc M, Petrov MS, Goodarzi MO, Fisher WE, Habtezion A, Lugea A, Pandol SJ, Hart PA, Andersen DK (2017). "Diabetes Mellitus and Obesity as Risk Factors for Pancreatic Cancer". J Acad Nutr Diet. doi:10.1016/j.jand.2017.07.005. PMID 28919082.
16. ↑ Kollarova H, Azeem K, Tomaskova H, Horakova D, Prochazka V, Martinek A, Shonova O, Sevcikova J, Sevcikova V, Janout V (2014). "Is physical activity a protective factor against pancreatic cancer?". Bratisl Lek Listy. 115 (8): 474–8. PMID 25246281.
17. ↑ Coughlin, SS. "Predictors of pancreatic cancer mortality among a large cohort of United States adults". Cancer Causes Control. 11 (10): 915-23. PMID 11142526. `|access-date=` requires `|url=` (help)
18. ↑ Zheng, W. "A cohort study of smoking, alcohol consumption, and dietary factors for pancreatic cancer (United States)". Cancer Causes Control. 4 (5): 477-82. PMID 8218880. `|access-date=` requires `|url=` (help)
19. ↑ Larsson, Susanna. "Fruit and vegetable consumption in relation to pancreatic cancer risk: a prospective study". Cancer Epidemiology Biomarkers & Prevention. 15: 301–305. PMID 16492919. `|access-date=` requires `|url=` (help)
20. ↑ 20.0 20.1 Kuroczycki-Saniutycz S, Grzeszczuk A, Zwierz ZW, Kołodziejczyk P, Szczesiul J, Zalewska-Szajda B, Ościłowicz K, Waszkiewicz N, Zwierz K, Szajda SD (2017). "Prevention of pancreatic cancer". Contemp Oncol (Pozn). 21 (1): 30–34. doi:10.5114/wo.2016.63043. PMC 5385470. PMID 28435395.
21. ↑ Barak Y, Fridman D (2017). "Impact of Mediterranean Diet on Cancer: Focused Literature Review". Cancer Genomics Proteomics. 14 (6): 403–408. doi:10.21873/cgp.20050. PMID 29109090.
22. ↑ http://news.bbc.co.uk/1/hi/health/5334534.stm
23. ↑ Jiao L, Chen L, White DL, Tinker L, Chlebowski RT, Van Horn LV, Richardson P, Lane D, Sangi-Haghpeykar H, El-Serag HB (2018). "Low-fat Dietary Pattern and Pancreatic Cancer Risk in the Women's Health Initiative Dietary Modification Randomized Controlled Trial". J. Natl. Cancer Inst. 110 (1). doi:10.1093/jnci/djx117. PMID 28922784.
24. ↑ http://www.webmd.com/content/article/127/116673.htm
25. ↑ Kerr J, Anderson C, Lippman SM (2017). "Physical activity, sedentary behaviour, diet, and cancer: an update and emerging new evidence". Lancet Oncol. 18 (8): e457–e471. doi:10.1016/S1470-2045(17)30411-4. PMID 28759385.
26. ↑ http://www.forbes.com/forbeslife/health/feeds/hscout/2006/09/14/hscout534925.html
27. ↑ "Plasma Folate, Vitamin B6, Vitamin B12, and Homocysteine and Pancreatic Cancer Risk in Four Large Cohorts -- Schernhammer et al. 67 (11): 5553 -- Cancer Research". Retrieved 2007-06-04.
28. ↑ "United Press International - Consumer Health Daily - Briefing". Retrieved 2007-06-04.
29. ↑ Zheng J, Guinter MA, Merchant AT, Wirth MD, Zhang J, Stolzenberg-Solomon RZ, Steck SE (2017). "Dietary patterns and risk of pancreatic cancer: a systematic review". Nutr. Rev. 75 (11): 883–908. doi:10.1093/nutrit/nux038. PMID 29025004.
30. ↑ Grosso G, Bella F, Godos J, Sciacca S, Del Rio D, Ray S, Galvano F, Giovannucci EL (2017). "Possible role of diet in cancer: systematic review and multiple meta-analyses of dietary patterns, lifestyle factors, and cancer risk". Nutr. Rev. 75 (6): 405–419. doi:10.1093/nutrit/nux012. PMID 28969358.

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