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Pancreatic
Cancer and African Americans
The pancreas is a long,
thin organ located in the abdomen. The pancreas secretes enzymes involved in
the digestion of food. It also produces
insulin and glucagon, which are hormones that
regulate blood sugar levels. The
pancreas is surrounded by the liver, spleen and stomach. The location of the
pancreas makes it hard to detect cancers of the pancreas.
Pancreatic cancer is the fourth leading cause of cancer
death in the United States and the fifth leading cause of cancer death
worldwide. Cancer of the pancreas accounts
for only about 2% of the cancers diagnosed each year. However, the five-year
survival rate is less than 5%, making pancreatic cancer a leading cause of
cancer death.
The incidence of
pancreatic cancer is 50-90% higher in African Americans than in any other racial
group in the United States. Not only is
pancreatic cancer more common among African Americans, but African Americans
also have the poorest prognosis of any racial group because they often are
diagnosed with advanced, and therefore, inoperable cancer. African Americans also are less likely to
receive surgery than any other racial group in the United States.
The
incidence of pancreatic cancer is 50% to 90% higher in African Americans than
in any other race in the United States.
Many studies have been conducted to determine why there is
an increased risk of pancreatic cancer among African Americans. These studies suggest that environmental and
socioeconomic factors may be important.
Cigarette smoking, which causes about 25% of pancreatic cancer, is more
common among African Americans and therefore may partially explain why
pancreatic cancer is more common in African Americans. Other risk factors for pancreatic cancer that
are more common in African Americans include diabetes mellitus, pancreatitis,
and being overweight.
Cigarette smoking is the most preventable cause of
pancreatic cancer. Cigarette smoking accounts for 25-30% of pancreatic
cancers. Smoking cigarettes doubles the
risk of pancreatic cancer, regardless of race. Smoking rates among African
American adults historically have been higher than among the general U.S.
population. However, in recent years smoking rates for blacks and whites are
similar.
Cigarette smoking is the most
preventable cause of pancreatic cancer.
The risk of pancreatic cancer is elevated in diets high in
fat and calories. Processed meat high in nitrates, such as bacon and bologna, also
increase the risk. The human body may process nitrates into cancer causing
chemicals, called carcinogens.
The risk of pancreatic cancer increases with body mass,
regardless of racial group. However, it
has been observed that obesity is more common among African American as
compared to other racial groups. This may help to explain the increased
incidence of pancreatic cancer among African Americans.
Low income is associated with an increased risk of
pancreatic cancer for several reasons. First, individuals who earn lower
incomes tend to smoke more and smoking doubles the risk of pancreatic
cancer. Also, people who earn low
incomes are less likely to receive proper nutrition and healthcare. According to the U.S. Census Bureau, African
Americans accounted for about one quarter of the U.S. population in poverty in
2001.
Blacks are nearly twice as likely as whites to have diabetes
mellitus (sugar diabetes). There are two types of diabetes, Type I and Type II.
Type I diabetes, sometimes called juvenile diabetes, generally affects younger
individuals and is caused by damage to the pancreatic cells that secrete
insulin. Individuals with Type I usually
become insulin dependent. Type I diabetes has not been linked to pancreatic
cancer. However, Type II diabetes, which
tends to occur in adults, has been shown to double the risk of pancreatic
cancer. Type II diabetes is associated
with obesity and lack of exercise.
Diabetes can sometimes be caused by pancreatic cancer.
Pancreatitis is an inflammatory disease of the
pancreas. Pancreatitis may either be
acute (sudden and severe) or chronic (long-standing). Individuals that have had
repeated attacks of acute pancreatitis can develop chronic pancreatitis.
The risk of pancreatic cancer is elevated in all patients
with pancreatitis and African Americans are at the highest risk of developing
pancreatitis of any racial group.
African Americans are twice as
likely as white Americans to have diabetes mellitus. Type II diabetes doubles
the risk of pancreatic cancer.
The overall risk of
pancreatic cancer due to “genes” is thought to be the same for most racial
groups. It is believed that 5-10% of
patients develop pancreatic cancer because of an inherited factor. For more
information on the genetic basis of pancreatic cancer see genetic counseling Web
page link.
Reducing Risk
The best way to
reduce your risk of pancreatic cancer is to quit smoking if you smoke, to eat a
diet high in fruits and vegetables and low in processed meats, and to lose
weight if you are heavy.
What can you do to
help the fight against pancreatic cancer?
If you or a member
of your family has been diagnosed with pancreatic cancer you can help us study
this disease by participating in research studies. The National Familial Pancreas Tumor Registry
at Johns Hopkins is a research study working to discover risk factors for
pancreatic cancer as well as ways to detect pancreatic cancer at an early,
curable stage.
To participate in
our research studies, click here: pancreas@jhmi.edu to send an e-mail, or contact us at,
The NFPTR
The Johns Hopkins Hospital
CRB II, Room 341
1550 Orleans Street
Baltimore, MD 21231
Phone: (410) 955-3502
Fax: (410) 614-0671
Email: pancreas@jhmi.edu