HJNO May/Jun 2023

54 MAY / JUN 2023 I  HEALTHCARE JOURNAL OF NEW ORLEANS ONCOLOGY DIAL GUE COLUMN ONCOLOGY Pancreatic Cancer Screening: WHY, WHO, & HOW Pancreatic cancer remains a fear of many, and, unfortunately, a reality to an increasing number of patients in our community. Pancreas cancer is not among the top eight in most common cancers in the U.S. However, it accounted for more deaths in 2022 than breast cancer, prostate cancer, or leukemia. These disparities are partially due to limited medical advances in pancreatic cancer but largely occur due to the lack of early detection. stages at diagnosis. Other exposures such as heavy metals, benzenes, and heavy alcohol use are also linked to pancreatic cancer. An area of continued research is the relation- ship between obesity, diabetes mellitus, and pancreatic cancer. A 2014 meta-analysis of pre-diabetes and cancer found that even small increments of elevated blood sugar lead to increase incidence of pancreatic cancer. However, metformin, a medication commonly used in Type 2 diabetes, may be linked to better survival rates in early stage pancreatic cancer. Other less defined risk fac- tors include periodontal disease, low physical activity, and chronic pancreatitis. Evidence regarding other risk factors that are com- monly asked about which may or may not play a role in pancreas cancer remains con- flicting. These risk factors include dietary habits, vitamin D levels, and the presence of an autoimmune disease. The strongest risk factor for pancreatic cancer is a family history. Approximately 8-12% of pancreatic cancers are thought to Early detection remains a key component of all cancer treatment. Fortunately for many cancers such as breast, colon, and cervical cancer, we have early detection screening tools that allow cancers to be found at earlier stages. Given the aggressive nature of pan- creatic cancer, methods of discovering who is at highest risk, who should be screened, and how we screen patients remains a work in progress. Effective screening starts with identify- ing a population who is at risk for a disease. Assessing demographics, identifying risk factors, and advancing our understanding of genetic risk all are important for finding those at the highest risk for pancreatic cancer. Risk factors for pancreatic cancer are not as clear as other diseases such as sun exposure and skin cancer. Though not as strong of a link as lung cancer, there is a clear relation- ship between smoking and pancreatic cancer. The pancreatic consortium found that long duration of low intensity smoking leads to higher rates of pancreatic cancer and later