Which of the following have been shown to be risk factors for development of adenocarcinoma of the pancreas?

a. Cigarette smoking

e. Prior gastrectomy

Most cases of pancreatic cancer have no obvious predisposing host factors. The most consistently observed risk factor for pancreatic cancer is cigarette smoking. Most studies estimate that smoking results in a two-to three-fold increase in risk of developing pancreatic cancer. Alcohol consumption has been implicated in some case-control studies of pancreatic cancer, but the overall evidence is inconsistent and alcohol is not likely to be a major factor in the development of the disease. Although considerable public interest was focused in the past few years on coffee consumption as a risk factor for pancreatic cancer, evidence linking coffee consumption to pancreatic cancer is not compelling

Abnormal glucose tolerance is present in about 80% of patients with pancreatic cancer, if carefully sought. Although diabetes and pancreatic cancer occur together far more frequently than would be expected by chance, persons with longstanding diabetes are not at increased risk of developing pancreatic cancer. Chronic pancreatitis is a significant risk factor for the development of pancreatic cancer. It appears that all forms of chronic pancreatitis are associated with an increased risk of pancreatic cancer, suggesting that it is the pancreatitis and not the injuring agent which is responsible for the augmented cancer risk. Studies indicate that patients who have previously undergone gastric resection may be from three to seven times more likely to develop pancreatic cancer than a control population. There have been several reports of familial clustering of pancreatic cancer. Recent epidemiological studies suggest that about 7% of pancreatic cancer patients have a positive family history of the disease. For most cases, however, no hereditary basis for pancreatic cancer has been identified.