Family history of pancreatic cancer: what it means for your risk

The NHS says anyone can get pancreatic cancer and it is not always clear what causes it. You might be more likely to get it if you are over 65, because it is not very common in people under 40, if you have certain medical conditions such as chronic pancreatitis, or if there is a history of pancreatic cancer in your family. It also says many pancreatic cancers are linked to lifestyle.

Pancreatic cancer may have no symptoms, or they may be hard to spot, which is part of why people with a strong family history are sometimes asked to be especially alert.

Cancer Research UK says most cases of pancreatic cancer are not linked to family history. But the risk is increased in people who have or had a first degree relative with it, meaning a parent, brother, sister or child. This might be because of an inherited gene change, or because people in the same family may share risk factors such as smoking or obesity.

The risk is higher in people who have or had two or more first degree relatives with pancreatic cancer, which is called familial pancreatic cancer, or a first degree relative diagnosed at a younger age. The charity says between 4 and 10 in 100 people with pancreatic cancer have familial pancreatic cancer.

Put simply, for most people with one affected relative the overall chance remains low, but the more relatives and the younger they were, the more it matters.

Cancer Research UK says pancreatic cancer can be part of a family cancer syndrome, in which an inherited gene change causes a number of different cancers in members of the same family. The risk is higher in people who carry a BRCA2 gene change, and there is evidence, though it describes it as mixed, that a BRCA1 gene change can also increase it. A PALB2 gene change is also linked to an increased risk.

It lists conditions that raise the risk: Peutz Jeghers syndrome, familial atypical multiple mole melanoma syndrome and Lynch syndrome. It says rarely pancreatitis can run in families (hereditary pancreatitis), which is not linked to drinking alcohol, and that people with it have a higher risk of pancreatic cancer.

If your family has several people with pancreatic cancer or related cancers such as breast, ovarian or melanoma, ask your GP whether a genetics referral is appropriate.

Beyond family history, Cancer Research UK identifies several other contributors, and the NHS lists lifestyle changes that can lower the chance of getting it.

• Smoking: more than 15% of UK cases are caused by smoking, and the risk in people who stopped 20 years ago is the same as for people who have never smoked.

• Overweight and obesity: more than 10% of UK cases.

• Long-term inflammation of the pancreas (chronic pancreatitis).

• Diabetes, which is linked to increased risk, although a growing pancreatic cancer may cause some cases of diabetes.

• Age: the risk increases as people get older.

The NHS says symptoms can include the whites of the eyes or skin turning yellow (jaundice), sometimes with itchy skin, darker pee and paler poo, loss of appetite or losing weight without trying, feeling tired, a high temperature, feeling or being sick, diarrhoea or constipation, pain at the top of the tummy and back that may feel worse when eating or lying down and better when leaning forward, and indigestion symptoms such as bloating.

It advises asking for an urgent GP appointment or help from NHS 111 if the whites of your eyes or skin turn yellow, you are being sick for more than 2 days, or you have diarrhoea for more than 7 days. See a GP if you have lost a noticeable amount of weight, if other symptoms get worse or do not improve after 2 weeks, or if you have a digestive condition whose symptoms are not improving after 2 weeks of usual treatment.

If you have a condition like irritable bowel syndrome you may get used to symptoms like these, but it is important to be checked if they change, get worse or do not feel normal for you.

The NHS says you cannot always prevent pancreatic cancer, but that making healthy changes can lower your chances. It suggests trying to lose weight if overweight, cutting down on red and processed meat such as ham, bacon and salami, trying to cut down on alcohol and avoid drinking more than 14 units a week, and trying to quit smoking.

It also says it is important to get any symptoms checked by a GP, even if you do not think you have a higher chance of getting it. If symptoms might be caused by cancer, finding it early may make it easier to treat.