Appointment

Surgical Oncology • Patient Education

What Causes Pancreatic Cancer? Causes and Risk Factors

Pancreatic cancer often causes no symptoms until it is advanced, so understanding what raises your risk, and which warning signs need prompt attention, matters more than for many other cancers.

By the surgical team at Surgical Associates of Southern Texas · Reviewed by the Review Team at Surgical Associates of Southern Texas · Published · Updated · 9 min read

General Surgeon Katy Houston

Concerned about a pancreatic mass or your risk?

Meet Dr. Murtaza Shakir, board certified in General Surgery and Complex General Surgical Oncology, in Katy or Sugar Land to review your imaging and options. Call (713) 955-9191, or send your details and our team will call you back.

Request a Call Back

THE SHORT ANSWER

The exact cause of pancreatic cancer is not fully understood, but smoking, type 2 diabetes, obesity, chronic pancreatitis, older age, family history and inherited gene changes such as BRCA2 all raise the risk. Smoking is the most important risk factor you can change. Most pancreatic cancers start in the cells lining the pancreatic ducts.

What Is the Pancreas and How Does Pancreatic Cancer Start?

The pancreas is a gland about 6 inches long that sits deep in the upper abdomen, behind the stomach. Its head lies on the right next to the first part of the small intestine, and its body and tail stretch to the left toward the spleen. It has two jobs:

  • Digestion: most of the pancreas makes enzymes that travel through small ducts into the small intestine to help break down food.
  • Blood sugar control: smaller groups of cells release hormones, including insulin and glucagon, into the bloodstream.

Pancreatic cancer begins when cells in the pancreas grow out of control and form a lump (tumor). Not every growth is cancer; some cysts and tumors are benign or precancerous. The American Cancer Society notes that about 95 percent of exocrine pancreatic cancers are adenocarcinomas, which usually begin in the cells lining the pancreatic ducts. Less common types include adenosquamous carcinoma and squamous cell carcinoma. Neuroendocrine tumors, which start in the hormone-making cells, behave differently and are treated differently.

What Causes Pancreatic Cancer?

Pancreatic cancer is caused by changes (mutations) in the DNA of pancreatic cells, but exactly why those changes happen in one person and not another is not well understood. Researchers have instead identified risk factors that make it more likely.

  • Acquired changes: most pancreatic cancers come from gene changes that build up during a person’s lifetime. These are not inherited and are not passed on to children.
  • Inherited changes: the American Cancer Society estimates that inherited gene changes cause up to 10 percent of pancreatic cancers.

Having a risk factor does not mean you will get pancreatic cancer, and many people who develop it have no obvious risk factor. Smoking, heavy drinking, diabetes and obesity are important contributors, but they are not the sole cause in most cases. If you are concerned about your risk, talk with your doctor.

Which Pancreatic Cancer Risk Factors Can You Change?

The most important changeable risk factor is smoking. According to the American Cancer Society:

  • Tobacco: people who smoke have about twice the risk of nonsmokers, and about 25 percent of pancreatic cancers are thought to be caused by cigarette smoking. Cigars and smokeless tobacco also raise risk, and risk falls after quitting.
  • Excess body weight: people with obesity are about 20 percent more likely to develop pancreatic cancer.
  • Type 2 diabetes: linked to higher risk, although the reason is not known.
  • Chronic pancreatitis: long-term inflammation of the pancreas is linked to higher risk and often occurs with heavy drinking and smoking.
  • Workplace chemicals: heavy exposure to certain chemicals, such as some used in dry cleaning and metal working, may raise risk.

Factors with less certain effects include heavy alcohol use, a diet high in red and processed meat, and physical inactivity. Avoiding tobacco, limiting alcohol, eating a healthy diet and keeping a healthy weight support the health of the pancreas and help with blood sugar control.

Which Risk Factors Can’t You Change?

Age, family history and inherited syndromes are the main risk factors you cannot change.

  • Age: almost all patients are older than 45, and about two-thirds are 65 or older.
  • Sex and race: men and African Americans are slightly more likely to develop it.
  • Family history: pancreatic cancer runs in some families, though most patients have no family history.
  • Inherited syndromes: including BRCA1 and BRCA2 mutations, PALB2, Lynch syndrome, Peutz-Jeghers syndrome, familial atypical multiple mole melanoma (FAMMM) syndrome and hereditary pancreatitis.
  • Other conditions: hepatitis B infection and liver cirrhosis have been linked to pancreatic cancer, but the evidence is less certain.

If several close relatives have had pancreatic, breast, ovarian or colon cancer or melanoma, ask your doctor about genetic counseling. Knowing your risk can guide decisions about testing and follow-up.

Have a Pancreatic Finding on a Scan?

Dr. Murtaza Shakir reviews imaging and biopsy results for pancreatic masses and cysts and explains surgical options for patients in Katy and Sugar Land. Call (713) 955-9191.

Request a consultation → (713) 955-9191

Why Is Pancreatic Cancer Often Found Late, and When Should You Worry?

Pancreatic cancer is often found late because the pancreas lies deep in the abdomen, early tumors usually cannot be felt, and symptoms often do not appear until the cancer has grown or spread. By the time symptoms start, the cancer may be advanced. See a doctor promptly for:

  • Yellowing of the skin or the whites of the eyes (jaundice), which can happen when a tumor narrows the bile duct
  • Dark urine, pale or greasy stools, or itchy skin
  • Pain in the upper abdomen that may spread to the back
  • Unintended weight loss or loss of appetite
  • New diabetes, especially with weight loss

Go to the emergency room for jaundice with fever and chills, severe abdominal pain, repeated vomiting, or vomiting blood or passing black stools. These symptoms have many causes besides cancer, but they need urgent evaluation. Our article on which symptoms indicate pancreatic cancer covers this in more detail.

How Do Doctors Diagnose Pancreatic Cancer?

Doctors diagnose pancreatic cancer with a combination of an exam, blood tests, imaging and a biopsy. The National Cancer Institute notes it is usually diagnosed with tests that make pictures of the pancreas and the area around it.

  1. History and physical exam: your doctor asks about your symptoms and family history and examines you for signs such as jaundice, abdominal tenderness or a mass.
  2. Blood tests: liver tests can show a blocked bile duct or spread to the liver. Tumor markers such as CA 19-9 and CEA may be measured, but they are not raised in everyone with pancreatic cancer.
  3. Imaging: CT is usually one of the first imaging tests. MRI or MRCP shows the pancreas and bile ducts in detail, and ultrasound may also be used. PET scans are not routine but can help find spread.
  4. Endoscopic ultrasound (EUS): a thin, flexible scope with an ultrasound probe passes through the mouth into the stomach to take close-up images of the pancreas and help obtain a biopsy.
  5. Biopsy: a small tissue sample is examined under a microscope to confirm cancer. ERCP can also collect cells from a narrowed bile duct and place a stent to relieve jaundice.
  6. Molecular and genetic testing: recommended for all people with pancreatic cancer, because results can guide treatment.

Before surgery, some patients have a diagnostic laparoscopy to look for small areas of spread that scans may have missed.

When Is Surgery an Option for Pancreatic Cancer?

Surgery is an option when the tumor can be completely removed, and the National Cancer Institute notes this offers the best chance of long-term survival. Because pancreatic cancer is often diagnosed late, complete removal is not always possible.

The type of operation depends on where the tumor is and how large it is, and on your overall health:

  • Whipple procedure (pancreaticoduodenectomy): removes tumors in the head of the pancreas.
  • Distal pancreatectomy: removes tumors in the body and tail of the pancreas.

When deciding whether surgery is right, surgeons look closely at the CT scan to see whether the tumor involves nearby major blood vessels or has spread to the liver or the lining of the abdomen, and at whether you are strong enough for a major operation. Pancreatic cancer care is planned by a team that usually includes a surgeon, a gastroenterologist and medical and radiation oncologists. Chemotherapy, and sometimes radiation, may be given before or after surgery to improve the chance of success, and chemotherapy is widely used for advanced cancer. When cancer cannot be removed, procedures such as a bile duct stent or a bypass can relieve jaundice or a blocked stomach. Learn more about pancreatic cancer care and surgical oncology.

Where Can Patients in Katy, Sugar Land and Houston Get a Pancreatic Cancer Evaluation?

Patients from Katy, Sugar Land and the wider Houston area can see Dr. Murtaza Shakir at Surgical Associates of Southern Texas to review a pancreatic mass, cyst or cancer diagnosis and discuss whether surgery is an option. Dr. Shakir is a board-certified general surgeon and is board certified in Complex General Surgical Oncology.

  • Bring your CT or MRI reports and images, and any EUS or biopsy results
  • Bring a list of your medications and any blood test results, including CA 19-9
  • Note your family history of cancer and any genetic test results

Read what a surgical oncologist does, learn about general surgery at the practice, meet Dr. Shakir, or call (713) 955-9191 and request a consultation.

Questions to Ask Your Surgeon About Pancreatic Cancer

  • Where in the pancreas is the tumor, and what type is it?
  • Can the tumor be completely removed, and does it involve major blood vessels?
  • Would I need a Whipple procedure or a distal pancreatectomy?
  • Should I have chemotherapy before surgery?
  • Do I need genetic testing, and should my family be tested?
  • If surgery is not possible, what can relieve my symptoms?
  • What will recovery involve, and how long will I be in the hospital?

Frequently Asked Questions

Is pancreatic cancer hereditary?

Sometimes. The American Cancer Society estimates that inherited gene changes, such as BRCA2 or Lynch syndrome, cause up to 10 percent of pancreatic cancers. Most cases come from gene changes acquired during life.

Does smoking cause pancreatic cancer?

Smoking is the most important changeable risk factor. Smokers have about twice the risk of nonsmokers, and about a quarter of pancreatic cancers are thought to be caused by cigarette smoking. Risk falls after quitting.

Can diabetes lead to pancreatic cancer?

Type 2 diabetes is linked to a higher risk. New diabetes, especially with weight loss, can occasionally be an early sign of pancreatic cancer, so it is worth mentioning to your doctor.

Is every pancreatic cyst or mass cancer?

No. Many pancreatic cysts are benign, and some are precancerous and can be watched or removed. A surgeon reviews the imaging and, when needed, an EUS biopsy to decide.

Can pancreatic cancer be cured with surgery?

Surgery offers the best chance of long-term survival when the tumor can be completely removed, usually combined with chemotherapy. Many cancers are found too late for surgery, which is why early evaluation of symptoms matters.

Key Takeaway

The exact cause of pancreatic cancer is not known, but smoking, diabetes, obesity, chronic pancreatitis, age, family history and inherited gene changes raise the risk. Because symptoms often appear late, jaundice, upper abdominal pain spreading to the back or unexplained weight loss need prompt evaluation. When the tumor can be completely removed, surgery offers the best chance of long-term survival.

Sources and Further Reading

This article is general education, not personal medical advice. For severe abdominal pain, fever with abdominal pain, heavy bleeding, or yellowing of the skin or eyes, seek emergency care.

Dr. Murtaza Shakir, board-certified general surgeon

Meet the Surgeon

Dr. Murtaza Shakir is a board-certified General Surgeon and is board certified in Complex General Surgical Oncology. He earned his medical degree at Aga Khan University, completed General Surgery residency at Riverside Methodist Hospital in Columbus, Ohio, and a two-year Surgical Oncology fellowship at the University of Pittsburgh Medical Center. He sees patients at Surgical Associates of Southern Texas in Katy and Sugar Land.

Meet the Surgeon

Schedule a Pancreatic Cancer Evaluation

Have a pancreatic mass, cyst or cancer diagnosis reviewed by Dr. Shakir in Katy or Sugar Land.

Request a Pancreatic Cancer Consultation

This page provides general information and is not a substitute for medical advice. For severe abdominal pain or other emergencies, call 911 or go to the nearest emergency room. Last updated October 16, 2026.