Young-onset of pancreatic cancer increased familial risk for the disease

The risk for developing pancreatic cancer increased sixfold compared to the general population for those people with multiple relatives with pancreatic cancer. Risk increased ninefold if one of those relatives had pancreatic cancer diagnosed younger than age 50.

To determine the implications of young-onset pancreatic cancer, researchers compared the incidence of young- and late-onset pancreatic cancer among 9,040 relatives from 1,718 families enrolled in The National Familial Pancreas Tumor Registry to that of the general population in the SEER database.

Standard incidence ratios (SIR) were calculated for familial pancreatic cancer and for sporadic pancreatic cancer. The familial group was defined as those having multiple first-degree relatives with pancreatic cancer. The sporadic group was defined as those having one relative, distant relatives or a spouse with pancreatic cancer.

Compared with the general population, the SIR of pancreatic cancer was higher among the familial group (6.79; 95% CI, 4.54-9.75) and the sporadic group (2.41; 95% CI, 1.04-4.74).

In the familial group, risk was highest among those with three first-degree relatives who had pancreatic cancer (SIR=17.02; P<.001) and lower among those with two (SIR=3.97; P=.005) or one first-degree relative (SIR=6.86; P<.001) with the disease.

In stratified analysis, those in the familial group with more than one family member with young-onset cancer (diagnosed when aged younger than 50 years) had greater risk for developing pancreatic cancer (SIR=9.31; 95% CI, 3.42-20.28) than those with family members with late-onset disease (SIR=6.34; 95% CI, 4.20-9.51). Conversely, no difference was observed in the sporadic group.

Risk increased as age of the youngest family member decreased (HR=1.55 per year of decreased age; 95% CI, 1.19-2.03). - by Christen Haigh

Brune KA. J Natl Cancer Inst. 2009;102:119-126.

This is yet another example of the need to obtain a family history and to be more thorough with the families of young cancer patients. However, although it is important to be aware of these possible relationships, the incidence of familial pancreas cancer is still quite low.

- Alan P. Venook, MD
HemOnc Today Editorial Board member