Pancreatic cancer age of onset

introduction

Pancreatic cancer (Pancreatic cancer) occurs more often at an advanced age, most frequently between the ages of 55 and 70 (80% of pancreatic carcinomas).
Overall, women and men are equally often affected, but the mean age of onset for men is 69 years and for women 76 years. Therefore, men under the age of 70 are more likely to develop pancreatic cancer than women.
Children are much less likely to develop pancreatic cancer than adults, but the disease can in principle occur at any age. The risk of developing pancreatic cancer increases significantly with age.

Frequencies

Pancreatic cancer accounts for around 2-3% of all malignant cancers in adults.
In Germany and Europe, 9-12 people per 100,000 people develop this tumor every year. The incidence of pancreatic cancer has increased steadily in recent years.
Since the end stage of pancreatic cancer has usually already been reached in Diganosis and the tumor is very aggressive, this is the case Cancer the fifth leading cause of cancer-related death worldwide. Experts attribute this increase in the number of diseases to the fact that life expectancy is increasing overall, which means that more and more people reach the age at which the likelihood of developing pancreatic cancer increases significantly.

Age as a risk factor

The causes for the development of pancreatic cancer are largely unknown.
Old age is the most reliable and most important risk factor for pancreatic cancer.
In addition, ethnic origin (highest pancreatic cancer death rate in black population), cigarette smoking, heavy alcohol consumption and being very overweight have already been proven to be risk factors.
In addition, there also seems to be familial predispositions for pancreatic cancer, which have special features in the genetic information (Gene mutations) are inherited. People whose families have a first-degree relative (Father, mother, siblings) who already have pancreatic cancer are two to three times more likely to develop the disease as well. But only about 5% of pancreatic cancers are genetic.
Longstanding chronic inflammation of the pancreas and type 2 diabetes mellitus can also increase the risk of pancreatic cancer.

Why does pancreatic cancer develop in old age?

Cancer can develop anywhere in the body and at any age. The human body cells constantly renew themselves through cell division and old or broken cells die. So there is usually a balance between cell growth and cell death (Apoptosis).
Now it can happen that a damaged cell does not die due to a defect in the genetic information, but divides and multiplies in an uncontrolled manner despite increasing defects. The daughter cells of this defective cell also contain the changed genetic information, and further deviations and damage can result from further cell division. This creates a tumor that can grow uncontrollably.
Pancreatic cancer is a malignant (malignant) Tumor that grows into and destroys healthy tissue. It usually starts from the so-called epithelial cells of the pancreatic ducts and often it even forms settlements (Metastases) in other organs.

Why does pancreatic cancer develop particularly often in old age?
Human body cells have certain control mechanisms that ensure that cell division takes place in a controlled manner and that defective cells die. Certain guardian genes (so-called tumor suppressor genes) monitor the correct cell division and initiate repair mechanisms if necessary.
The older a person gets, the weaker these control mechanisms become and the likelihood that defects will arise in the guardian genes increases. If these guardian genes are switched off and can no longer ensure that a cell dies, the cell becomes immortal and can continue to multiply in an uncontrolled manner.
This increases the likelihood of developing a tumor (also of pancreatic cancer) with increasing age.

Pancreatic cancer in children

Malignant diseases of the pancreas are very rare in children.
The rare pancratoblastoma is a tumor of the epitzel cells of the pancreas, 90% of which occurs in early childhood and only in 10% of cases in adults. The five-year survival rate for this tumor is up to 80%.
With an average age of about 20 years, the very rare solid pseudopapillary pancreatic tumor occurs particularly in women. This pancreatic cancer is slightly malignant (low-grade malignant), but has a good prognosis in the case of a complete surgical removal.
In certain regions of India it happens that children develop chronic pancreatitis, which leads to a blood sugar disorder and later the development of pancreatic cancer. Due to globalization and the resulting intermingling of peoples, these forms of disease are also being treated in Central Europe.

Age peak in various tumors of the pancreas

By far the most common malignant pancreatic cancer is this ductal adenocarcinoma. In Germany, 18 people per 100,000 people develop it every year. This makes it the third most common tumor of the digestive tract.
Most of the time it is ductal adenocarcinoma localized in the head of the pancreas and has a relatively poor prognosis, since it is only operable in 10-15% of cases at the time of diagnosis. This pancreatic cancer is most common between the ages of 6 and 8.

Other types of pancreatic tumors are much rarer, for example intraductal papillary-mucinous tumors of the pancreas in men slightly more often than in women and accumulate between the ages of 60 and 70 years. The prognosis for this pancreatic cancer is very good. This tumor arises within the duct system of the pancreas (intraductal).

The serous cyst adenoma the pancreas is a benign tumor. It is mainly observed in older women and is diagnosed by chance in up to a third of cases. Older women are affected up to four times as often as men.
Serous cyst adenomas of the pancreas are rare and have a complete surgical removal (Resection) a good prognosis.

In contrast, the term mucinous-cystic tumor of the pancreas is used to summarize benign and malignant tumors, which particularly affect women between the ages of 40 and 60.
If such a tumor is completely removed, the prognosis is good; with malignant tumors the five-year survival rate is around 75%.

Acinar cell carcinoma is a rare form of pancreatic cancer. It is twice as common in men than women, and the peak age is between 55-65 years. These tumors are often discovered late, and liver metastases are often found at the time of diagnosis.

The insulinoma is a rare, in 90% benign tumor of the insulin-producing cells of the pancreas. It is the most common hormone-active (insulin-forming) Pancreatic cancer, is caused by symptoms of hypoglycaemia (Food cravings, dizziness, sweats) and is found about twice as often in women as in men.
Insulinoma can occur at any age, but the most common pancreatic cancer is around the age of 50.

A gastrinoma and the associated clinical picture, the so-called Zollinger-Ellison syndrome, can arise not only from a tumor of the pancreas, but also in the small intestine. Gastrinomas are malignant in 60% of cases, are extremely rare and usually occur between the ages of 30 and 60 years.
This type of pancreatic cancer produces the hormone gastrin, which stimulates the production of stomach acid. The increase in acidity in gastrinoma often leads to stomach and duodenal ulcers.