How dietary factors can affect the developmentof cancer

Variables that appear to affect the development of cancer of the pancreas include a diet high in fat and/or cholesterol and excessive cigarette smoking. There are a number of variables that appear to play no role in the development of cancer ofthe pancreas including alcohol, clinically apparent pancreatitis, and weight. In women there exists a positive correlation with diabetes and cholecystectomy. There are three ways in which tobacco smoke can increase the risk of cancer of the pancreas: containment of tobacco carcinogens in bile which can be refluxed from the bile duct into the pancreatic duct; tobacco carcinogens which can be distributed by the blood stream (such sub stances could include certain nitrosamines, some of which are known to be organ specific to the pancreas of experi mental animals); and, to the extent that cigarette smoking can increase blood lipids and since blood lipids may affect the development of pancreatic cancer, this could be another mechanistic pathway. How dietary factors can affect the developmentof cancer of the pancreas is a question that needs answering. The possibility of in vivo transformation of cholesterol to a cholesterol epoxide is just one of the possibilities that must be cu@1.,1dered.This presentation summarizes the up-to-date epidemiological evidence suggesting the relationship be tween diet and cigarette smoking to cancer of the pancreas, makes recommendations for future epidemiological and experimental studies that should be undertaken, and pro poses preventive steps that should be carried out.