The Role of Hyperinsulenemia as a Risk Factor for Pancreatic Cancer

Background: Pancreatic cancer is associated with a very severe prognosis and identification of risk factors is essential. Diabetes and obesity are both established risk factors, and they both cause hyperinsulenemia. With this review we wished to appraise the evidence of a role of high insulin levels in causing pancreatic cancer. Methods: We searched PubMed, Embase, Cochrane Library and Medline, and all evidence on potential pathophysiology of hyperinsulenemia and pancreatic cancer was included. Metaand pooled-analysis on epidemiological evidence are reported, as well as individual studies were as appropriate for specific topics (role of therapies, central adiposity and role of physical exercise). Conclusion: Hyperinsulenemia, and possibly hyperestrogenism secondary to a metabolic syndrome, are important elements in the pathogenesis of pancreatic cancer. Modification of certain life-style factors (exercise and weight loss) appears to modify the risk of pancreatic malignancy.