Current epidemiology of pancreatic cancer: Challenges and opportunities

Abstract

Pancreatic cancer (PC) is an increasingly common disease worldwide. Having a better understanding of worldwide and regional epidemiologic features and risk factors of PC is essential to identify new approaches for prevention, early diagnosis, surveillance, and treatment. In this article, we review the epidemiologic features and risk factors for PC and discuss opportunities and challenges of PC future treatment.

Keywords: Pancreatic cancer; epidemiology; novel strategies; risk factors; survival.

1

High concentrations of insulin are able to activate insulin-like growth factor 1 (IGF-1) receptor. Furthermore, increased insulin can also down-regulate IGF binding protein-1, leaving more bioavailable IGF-1 to promote cell proliferation. Recent study proved that IGF-1 promotes growth and proliferation of cancer cells by activating PI3K-mTOR and MAPK signaling pathways. Adipose cells around the pancreas can produce an obesity-associated inflammatory environment. Cancer-associated adipocytes as well as infiltrating inflammatory and immune cells in the peripancreatic adipose tissue microenvironment can secrete higher than normal levels of adipokines, proinflammatory cytokines, chemokines, and growth factors, which may accelerate pancreatic cancer (PC) progression. In obesity, increasing leptin levels and decreasing adiponectin levels are associated with a more aggressive malignant phenotype involving the activity of leptin-Notch axis, which promotes invasiveness of PC cells.