Purple ribbon, symbol of pancreatic cancer ©BelgaImage
According to figures from the Belgian Cancer Registry, there are now twice as many patients with pancreatic cancer compared to 15 years ago. This is what the Flemish daily De Morgen reports this week, which contacted several hospitals to find out if this trend was reflected on the ground. Result: between the pre-Covid period and January 2023, the increase is 25 to 60% depending on the establishment. A trend that is all the more worrying because pancreatic cancer is particularly deadly. According to the Cancer Foundation, the survival rate is only 13%. The organization states that the “risk factors are not well known“, but she notes despite everything that several causes can be singled out.
The cigarette, this eternal enemy
For the Cancer Foundation, the main risk of developing pancreatic cancer is smoking. “Smokers are twice as often affected as non-smokersshe says. At the individual level, cigarette consumptiontriple the risk of pancreatic cancer“, precise the Arc Foundation for cancer research, which estimates that 30% of cases recorded worldwide are linked to smoking (active and passive).
The question is to know why the number of pancreatic cancers is exploding while Belgians are gradually turning away from tobacco. According to the latest figures, there are now 24% of smokers and despite a rebound in this percentage during the Covid crisis, the trend is indeed downward. In 2013, they were 27%, according to the latest survey by the Cancer Foundation.
To read: What do smokers need to stop smoking?
According to professor and pancreatic surgeon Nouredin Messaoudi, from UZ Brussel, the effects of smoking can however be felt in the long term. “The effect of people in their thirties quitting smoking only becomes noticeable at age 70“At this level, he says to the Morgen. However, 84% of cases of pancreatic cancer recorded in Belgium appear following the age of 60, hence the need to remain attentive to possible signs of the onset of the disease for smokers and ex-smokers.
Obesity, alcohol and diabetes: the deadly combo
Another factor in pancreatic cancer is obesity, especially in cases of “diet high in animal fats and protein“, specifies the Foundation once morest cancer. A high and regular consumption of alcohol does not help since it promotes the development of local chronic inflammation of the pancreas, adds the Arc Foundation. Then it is without counting on type 2 diabetes. People who have developed this disease have twice the risk of suffering from pancreatic cancer.
To read: Figures, treatment, cost… Where are we with diabetes?
On this last point, the InterMutualiste Agency (IMA) notes that between 2008 and 2017, more and more Belgians are diabetic. According to his data, the percentage of patients in Belgium increased from 5.1% to 6.1% from 2008 to 2017. After the age of 65, this figure jumped from 15-16% to 17-18%, i.e. to once more the age when the majority of pancreatic cancers develop. But that might only be the tip of the iceberg. The Sciensano Health Institute asserts that “a quarter of patients suffering from type 2 diabetes in Belgium are unaware of this diagnosis. The prevalence of diabetes in Belgium is therefore probably higher».
As for overweight, it now concerns 59.5% of adults (67% in men, 52% in women), according to a report published in 2022 by the WHO. It also appears that 23% of the Belgian population is described as obese (24% among men, 22% among women). At European level, the number of obese adults increased by 138% between 1975 and 2016.
The gene lottery
Among the latest known risk factors pointed out by the Cancer Foundation, there are family predispositions. In some people, a particular genetic mutation has been identified, sometimes not. When this is the case, it is in particular “mutations in the BRCA 1 or 2 genes (involved in hereditary forms of breast and ovarian cancer), or in the CDKN2A gene (which also increases the risk of melanoma)». «Hereditary diseases such as Peutz-Jeghers syndrome or hereditary pancreatitis are also risk factors», note l’organisation.
To read: “When we talk regarding cancers, we have not yet reached the peak of the wave”
However, scientific research must make progress in this area to understand all the ins and outs. According to the Arc Foundation, “it is estimated that 90% of the predisposition genes involved in the development of pancreatic cancers have yet to be identified».
