PANCREATIC CANCER: RISK FACTORS, CHALLENGES IN EARLY DETECTION AND PREVENTION STRATEGIES

• DOI: https://doi.org/10.22533/at.ed.15951125180215

• Palavras-chave: Pancreatic Cancer", "Early Detection", "Biomarkers", "Screening Strategies" and "Imaging Techniques

• Keywords: Pancreatic Cancer", "Early Detection", "Biomarkers", "Screening Strategies" and "Imaging Techniques

• Abstract:

  Pancreatic cancer has increased globally, especially in developed countries, and is a major public health concern. This increase is associated with an ageing population, changes in lifestyle, advances in diagnosis and greater longevity. Despite advances in diagnosis, the majority of cases are still discovered in advanced stages, which reduces survival rates, which remain below 10% at five years. Older age, smoking, obesity, unhealthy diets and exposure to toxic substances are the main risk factors. Pancreatic cancer is predominantly pancreatic ductal adenocarcinoma (PDAC), which accounts for 90% of cases and has a high mortality rate. Pancreatic neuroendocrine tumors (PNETs) and cystic neoplasms, which account for 5% of cases, have a better prognosis when diagnosed early. The incidence of pancreatic cancer is expected to continue rising, necessitating effective prevention and screening strategies.
  Traditional risk factors include smoking, obesity, type 2 diabetes, chronic pancreatitis and genetic factors such as mutations in the BRCA2, PALB2 and STK11 genes. In addition, epigenetic alterations, such as DNA methylation and regulation by microRNAs, are also associated with pancreatic cancer. The use of risk scores based on artificial intelligence could improve risk prediction and early detection, allowing for more effective screening in high-risk populations.
  Early detection is challenging due to the difficulty in identifying tumors at early stages. Imaging tests such as computed tomography (CT) and magnetic resonance imaging (MRI) are fundamental, but with limitations for detecting small tumors. Tumor biomarkers, such as CA 19-9, have limited utility, and research is focused on new biomarkers to improve diagnostic accuracy. Screening programs for high-risk individuals, such as those with genetic mutations, can increase the chances of early diagnosis and improve survival.
  Preventing pancreatic cancer involves adopting healthy habits, such as a balanced diet, regular physical activity and smoking cessation. Controlling obesity and type 2 diabetes is also essential. Research is investigating the use of chemopreventive agents, such as metformin and aspirin, to reduce the risk, with promising results, but more studies are needed. Prevention and early detection are crucial to improving the prognosis and reducing the mortality associated with pancreatic cancer.