Diet and pancreatic cancer: many questions with few certainties

A. Cappellani 1, A. Cavallaro1, M. Di Vita 1, A. Zanghi 1, G. Piccolo 1, E. Lo Menzo 2, V. Cavallaro 3, M. Malaguarnera 4, A. Giaquinta 5, M. Veroux 5, L. Cimino 6, M. Berretta 7

¹ Department of Surgery, General Surgery and Breast Unit, University of Catania (Italy)
² Division of Laparoscopic and Bariatric Surgery, University of Maryland, Baltimore (USA)
³ Department of Surgery, General and Digestive Surgery Unit, University of Catania (Italy)
⁴ Department of Bichemistry, Medical Chemistry and Molecular Biology, University of Catania (Italy)
⁵ Department of Surgery, Transplantation and Advanced Technologies, University of Catania (Italy)
⁶ Section of Endocrinology, Andrology and Internal Medicine, Department of Internal Medicine and Systemic Diseases, University of Catania (Italy)
⁷ Department of Medical Oncology, National Cancer Institute – I.R.C.C.S. Aviano (Italy)

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• Oncology

Background, Objectives: Pancreatic cancer ranks fourth for cancer mortality for men and women in the United States.
This is a particularly devastating cancer since the case-fatality proportion approaches 90% within 12 months following diagnosis. Therefore, understanding the etiology and identifying the risk factors are essential for the primary prevention of this deadly disease.
Of the few potentially modifiable risk factors that have been identified, cigarette smoking, history of diabetes mellitus, and obesity seem to be among the most consistent, but the effect of dietary factors is still unclear. The aim of our study is to review of the literature examining the potential role of carbohydrates, fatty acids, meat, fruit and vegetables, alcohol.

Discussion: Although large prospective cohort studies with questionnaire based analyses will continue to have much to offer in defining predisposing factors for difficult diseases, such as pancreatic cancer, unfortunately dietary questionnaires do not reflect the bioavailability of the nutrients from various foods, the level of absorption from the digestive tract, or individual differences in metabolism.

Conclusions: Greater use of participant-derived biological samples, banked plasma, germline DNA, and tumour tissue samples may help to the understanding of pancreatic cancer pathogenesis.

Corresponding Author: Alessandro Cappellani, MD; e-mail: alecap@unict.it