Pancreatic Cancer Exposome Profile to Aid Early Detection and Inform Prevention Strategies.

Maria J Monroy-Iglesias,Mieke Van Hemelrijck,Aida Santaolalla,Saoirse Dolly,Debashis Sarker,Kiruthikah Thillai

doi:10.3390/jcm10081665

Maria J Monroy-Iglesias, Mieke Van Hemelrijck + Show 4 more

Open Access

https://doi.org/10.3390/jcm10081665

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Abstract

Pancreatic cancer (PCa) is associated with a poor prognosis and high mortality rate. The causes of PCa are not fully elucidated yet, although certain exposome factors have been identified. The exposome is defined as the sum of all environmental factors influencing the occurrence of a disease during a life span. The development of an exposome approach for PCa has the potential to discover new disease-associated factors to better understand the carcinogenesis of PCa and help with early detection strategies. Our systematic review of the literature identified several exposome factors that have been associated with PCa alone and in combination with other exposures. A potential inflammatory signature has been observed among the interaction of several exposures (i.e., smoking, alcohol consumption, diabetes mellitus, obesity, and inflammatory markers) that further increases the incidence and progression of PCa. A large number of exposures have been identified such as genetic, hormonal, microorganism infections and immune responses that warrant further investigation. Future early detection strategies should utilize this information to assess individuals’ risk for PCa.

Highlights

Pancreatic cancer (PCa) is one of the leading causes of cancer mortality worldwide, in more developed countries [1]
To characterize the risk profile of PCa using the exposome approach, we have reported studies based on whether they assessed a component of internal, general external or specific external exposure and/or a combination of exposure patterns
When looking at dietary factors in combination with other risk factors we found a synergistic association between inflammatory diet, smoking and diabetes mellitus (DM)

Summary

Introduction

Pancreatic cancer (PCa) is one of the leading causes of cancer mortality worldwide, in more developed countries [1]. PCa ranks seventh for cancer mortality globally, accounting for 495,773 new cases and causing 466,003 deaths in 2020 [2]. The lack of specific symptoms means PCa is often diagnosed at an advanced stage and remains one of the most lethal malignancies with a 5-year survival rate of 5–10% [3,4]. The majority of cases are often already incurable at the time of diagnosis, and even with palliative chemotherapy have a median overall survival of 6–12 months [9]. The risk of recurrence is high and the majority of patients relapse, with a 5-year survival rate of 29% [10]

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