Pancreatic cancer rarely produces clear symptoms in its early stages, so it is often detected only after the disease has advanced. According to the Korea Central Cancer Registry, patients diagnosed between 2019 and 2023 had a five-year relative survival rate of 17.0%, the lowest among all cancer types. No established prevention guidelines exist yet, but a series of recent studies has found that reducing known risk factors through oral care, quitting smoking and weight management can lower the likelihood of developing the disease.
Research teams at New York University School of Medicine, the American Cancer Society, researchers in Qingdao, China, and the Cedars-Sinai Medical Center in the United States recently published findings in journals including JAMA Oncology and Pancreas showing that oral microbes, smoking and visceral fat each raise the risk of pancreatic cancer. The conclusions were drawn from large-scale cohort observations and meta-analyses of earlier research.
The NYU medical school team tracked saliva samples from 122,000 adults over nine years. Comparing the oral microbes of 445 people diagnosed with pancreatic cancer during that period with 445 controls, the researchers identified a combination of 27 microbes — including three bacteria that cause gum disease and Candida fungi — as a risk marker, with the risk of developing the disease rising 3.5-fold for each one-standard-deviation increase in the marker. The suspected pathway is that swallowed oral microbes disrupt the microbial balance within the pancreas and trigger inflammation. Flossing between the teeth before brushing, and holding the toothbrush at a 45-degree angle against the gums, are recommended habits.
Smoking is another leading risk factor. The American Cancer Society estimated that smokers face about twice the risk of non-smokers and that roughly 25% of all cases are linked to smoking. Continued exposure to carcinogens accumulates oxidative stress and DNA damage, causing abnormalities in genes that regulate cell proliferation and death. Secondhand smoke is no exception. The Qingdao researchers, combining 14 earlier studies covering 5,560 patients, found that people exposed to secondhand smoke faced about 20% higher risk than those who were not.
Diet and weight management are also needed. The paper in the journal Pancreas reported that the proportion of fat within the pancreas is proportional to the amount of visceral fat, and that both figures are higher in patients with chronic pancreatitis. The Cedars-Sinai researchers explained that when fat accumulates in the pancreas, substances are secreted that stimulate inflammation and promote cell proliferation and migration, increasing cancer risk. Eating more whole grains, vegetables, fruit and legumes, cutting back on high-fat and high-calorie foods, and getting 150 to 300 minutes of moderate-intensity exercise a week are recommended.
National cancer registry statistics also show wide gaps in survival by stage. When the cancer is found while still confined to the pancreas, the five-year relative survival rate rises to 47.8%, but it falls to 2.4% when the disease is detected after spreading to other organs. Because early detection is difficult, managing risk factors is taking on greater weight.
