Pancreatic cancer is cancer that begins in the pancreas. A family history of pancreatic cancer is a risk factor for developing it, although most cases occur in people with no family history.

A 2022 review estimates that about 10% of pancreatic cancer cases are hereditary, and most sources echo this claim. It has a very low survival rate because it is difficult to detect in its early stages.

While most cases of pancreatic cancer are not hereditary, pancreatic cancer does involve changes in genes and is, in this sense, genetic. A 2019 review estimates that 90% of pancreatic cancer cases occur because of changes in the KRAS gene, which codes for the K-Ras protein.

Still, a number of preventable risk factors, such as obesity, exposure to toxic chemicals, smoking, diabetes, and chronic pancreatitis, play a key role in the development of pancreatic cancer. Addressing these risk factors may be the best way to lower a person’s lifetime risk.

This article explains whether pancreatic cancer is hereditary, including which types. It also details the causes and treatment.

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Pancreatic cancer can be hereditary. However, it usually is not. Only about 10% of cases are familial, according to a 2022 paper.

While pancreatic cancer is only sometimes hereditary, it is always genetic. Pancreatic cancer occurs when changes in genes cause cells to grow out of control. These changes can occur for many reasons, and researchers are still exploring all the potential causes.

Different types of pancreatic cancer include:

  • pancreatic adenocarcinoma
  • exocrine cancers such as
    • adenosquamous carcinomas
    • squamous cell carcinomas
    • signet ring cell carcinomas
    • undifferentiated carcinomas
    • undifferentiated carcinomas with giant cells
  • ampullary cancer

Who is most at risk?

Pancreatic cancer risk increases with age, with most people diagnosed over the age of 65. Certain inherited syndromes increase the risk of pancreatic cancer. However, there are other risk factors that play a more significant role.

Risk factors include:

  • smoking
  • being male
  • being over the age of 65
  • obesity
  • chronic pancreatitis
  • diabetes
  • exposure to toxic chemicals

A person’s risk may increase as the number of risk factors increases.

Certain inherited mutations may increase the risk of pancreatic cancer. They include:

  • BRCA1 and BRCA2 mutations, which also increase the risk of breast and ovarian cancer
  • PRSS1 gene mutations, which can cause familial pancreatitis
  • Lynch syndrome, which increases the risk of colorectal cancer, and which usually occurs in people with mutations in MLH1 or MSH2 genes
  • p16/CDKN2A gene mutations, which can cause familial atypical melanoma
  • PALB2 mutations, which can cause breast cancer
  • Peutz-Jeghers syndrome, which occurs because of mutations in the STK11 gene and may also cause polyps in the digestive system

Genetic mutations are unpredictable, and some people with these genes will not get cancer, while others will. So even when pancreatic cancer is hereditary, many different factors may play a role.

People with genetic mutations may need more frequent pancreatic cancer screenings. Early diagnosis increases the chance that a doctor can diagnose the cancer before it spreads. Pancreatic cancer is usually silent, spreading significantly before diagnosis, so early detection increases the chances of survival.

Like all types of cancer, pancreatic cancer occurs when cells grow out of control and too fast. This causes a tumor to form and eventually spread. This can damage the pancreas and other organs.

This uncontrolled growth begins with genetic changes. A 2019 paper reports that changes in the KRAS gene are the most common culprit, accounting for 90% of cases. This gene controls a protein responsible for cell growth and differentiation. A mutation in this gene can cause uncontrolled cell growth.

Many different risk factors can lead to pancreatic cancer. They include:

  • family history and inherited genetic syndromes, which account for about 10% of pancreatic cancer cases
  • being African-American
  • being over the age of 65
  • being male, which may be partly because of higher rates of smoking among men
  • smoking
  • diabetes
  • chronic pancreatitis
  • exposure to toxic chemicals
  • obesity

Pancreatic cancer has a very low cure rate, and 5-year survival rates range from just 5–15%. In the rare cases where a person gets a diagnosis before the cancer spreads, surgery may be able to cure it, and survival rates are higher.

Otherwise, the focus of treatment is to prolong a person’s life, often by a few months, and to reduce their pain.

Treatment options may include:

Pancreatic cancer is usually terminal cancer. Thus, many people have an interest in preventing it and understanding how it begins. While hereditary factors can play a role, they only contribute to about 10% of pancreatic cancer cases.

Managing preventable risk factors may help reduce the risk of pancreatic cancer and of many other health conditions. People with a family history of pancreatic cancer may wish to discuss testing and prevention options with a doctor.