A newly published study shows that patients with familial pancreatic cancer have twice the risk of having one first-degree relative with an extra-pancreatic malignancy than patients with sporadic pancreatic cancer. In addition, patients with familial pancreatic cancer had a higher risk of having precancerous lesions, but a lower rate of smoking. (Cancer. Online Oct. 14, 2014) Familial pancreatic cancer patients were defined as cases in which at least 1 first-degree relative also had pancreatic cancer. Andrew Biankin et al. at the Wolfson Wohl Cancer Research Centre, Glasgow University, Scotland, worked to identify the differences between patients with familial pancreatic cancer and those with sporadic pancreatic cancer. The study analyzed data from 766 patients with pancreatic ductal adenocarcinoma, 8.9% (68 cases) of which were familial pancreatic cancer. The investigators found that patients with familial pancreatic cancer had similar median survival compared to patients with sporadic pancreatic cancer with or without surgery (19.8 months vs. 17.4 months for patients with surgery, P=0.14; 7.2 months vs. 6.8 months for patients without surgery, P=0.61). Also, the mean age at disease diagnosis was similar in both groups (65.8 years vs. 66 years, P=0.89). However, in patients with parent-child familial pancreatic cancer, the mean age at disease diagnosis was significantly younger in the offspring than in the parental generation (60.6 years vs. 72.9 years, P<0.0001). Similarly, the proportion of patients with familial pancreatic cancer who had previous other malignancies was similar to that of patients with sporadic pancreatic cancer (14.7% vs. 10.3%, P=0.26). However, patients with familial pancreatic cancer were more likely to have 1 of their first-degree relatives with an extra-pancreatic malignancy (44.1% vs. 21.2%, P<0.0001). Further analysis suggested that first-degree relatives of patients with familial pancreatic cancer had a higher risk of developing melanoma (8.8% vs. 0.6%, P<0.0001) and endometrial cancer (2.9% vs. 0.6%, P=0.03) than first-degree relatives of patients with sporadic pancreatic cancer. The researchers also noted that patients with familial pancreatic cancer were more likely to have precancerous lesions found in surgically resected specimens compared to patients with sporadic pancreatic cancer (36.8% vs. 23.9%, P=0.03), and a lower percentage of patients were smokers at the time of diagnosis (8.8% vs. 28.2%, P=0.0003). Researcher Biankin noted, "The results of this study are important and suggest that genes we inherit from our parents play an important role in the lifetime risk of developing pancreatic cancer. In addition, the findings suggest that we need to pay attention to family history of pancreatic cancer in addition to family history of other malignancies when assessing the risk of pancreatic cancer in patients. Finally, our data also emphasize the importance of smoking cessation."