Which risk factors are most strongly associated with pancreatic adenocarcinoma?

• A. Alcohol consumption alone.
• B. Smoking, chronic pancreatitis, obesity, and family history.
• C. High-fiber diet.
• D. Regular exercise.

Answer: (B)

Pancreatic adenocarcinoma is most strongly linked to a combination of modifiable and nonmodifiable factors that reflect chronic pancreatic inflammation and genetic predisposition. Smoking is the key modifiable risk factor, consistently associated with increased risk. Chronic pancreatitis markedly raises risk due to long-standing inflammation and cellular turnover in the pancreas. Obesity contributes to cancer risk through insulin resistance and inflammatory mediators. A family history of pancreatic cancer or known genetic predispositions further elevates risk, indicating inherited susceptibility. In contrast, a high-fiber diet and regular exercise tend to be protective, and alcohol use alone does not stand out as the strongest independent risk factor for this cancer.