Risk factors for cancer of the pancreas

The descriptive epidemiology of cancer of the pancreas is hampered by the difficulty of differential diagnosis and the variation in diagnostic expertise and resources around the world. The condition is a disease of the elderly and there are few patients under 40 years of age. The disease is somewhat more common in American blacks than in whites. Two populations of Polynesian origin--Maoris and Hawaiians--show high incidence rates, especially in males. Geographic variation is not striking and is difficult to interpret. The most consistently observed exogenous risk factor is cigarette smoking, the disease being approximately twice as common in heavy smokers as in nonsmokers. In sharp contrast to chronic pancreatitis, pancreatic cancer does not appear to be related to use of alcoholic beverages. Recent observations of association of risk with coffee consumption and with use of decaffeinated coffee require further evaluation.