OCCURRENCE, TRENDS AND ENVIRONMENTAL ETIOLOGY OF PANCREATIC-CANCER

This review summarizes data on the occurrence, the trends, and the lif e-style, environmental, occupational and genetic determinants of pancr eatic cancer. Epidemiologic evidence implicates tobacco smoking as one cause. The evidence regarding alcohol consumption is inconsistent. Al though both positive and inconclusive findings are encountered, the bu lk of the evidence on coffee consumption is negative. Fat intake is Li nked with obesity and diabetes mellitus, which are risk factors for pa ncreatic cancer. Fruit and vegetable consumption appears to be protect ive. No occupational or environmental agent has been confirmed to incr ease the risk, but epidemiologic evidence is inconsistent. Little is k nown about the role of genetic polymorphisms of metabolic enzymes in p ancreas carcinogenesis. Pancreatic cancer shows high rates of mutation s of Ki-ms and losses or mutations of tumor suppressor genes (p53, p16 (INK4A), and SMAD4/DPC-4). Ki-ras mutations have been associated with Life-style factors in relation to pancreatic cancer, but the evidence is still scant and inconsistent.