Pancreatitis as a risk for pancreatic cancer (Reprinted from Gastroenterology Clinics of North America, vol 31, pg 663, 2002)

Pancreatic cancer remains one of the most recalcitrant of all cancers. As current treatment regimens for pancreatic cancer are inadequate, a major focus of research is to understand the pathways important for pancreatic cancer development, and to identify factors that can be modified to retard the development of pancreatic cancer. Smoking is the strongest risk factor amenable to modification. Other major risk factors include chronic pancreatitis and germ line genetic mutations. Epidemiologic studies of patients with chronic pancreatitis, cystic fibrosis, tropical pancreatitis, and hereditary pancreatitis prove that all forms of pancreatitis increase the risk of pancreatic cancer. Recent studies also demonstrate gene-gene and gene-environmental interactions that increase the risk of pancreatic cancer in the setting of chronic pancreatitis. Finally, the article outlines new guidelines that address the problem of whether or not patients with chronic pancreatitis should be screened for pancreatic cancer.