Background: The number of new cancer diagnoses is projected to increase by over 20% in Europe by 2035, and cancer is expected to become the leading cause of death worldwide. Pancreatic cancers, about 85% of which are pancreatic ductal adenocarcinomas, are highly lethal, with a 5-year survival rate generally not exceeding 10%. The pancreas and the salivary glands interact with one another via the action of growth factors such as epidermal growth factor (EGF). Endocrine disruptor (ED) exposure may affect the morphogenesis, structure, and function of an organ, and salivary glands are a sensitive target of endocrine disruption. Some of these chemicals have also been linked to various types of cancer, obesity and diabetes.

Objectives: To discuss the major risk factors for pancreatic cancer, especially the link between obesity, diabetes, and chemicals, i.e., endocrine disruptors, and the interplay between the pancreas and the salivary glands. To propose several hypotheses to explain how pancreatic carcinogenesis may occur through the interaction between the organs, the role of chemical exposure, and putative non-genomic alterations or mutational events that primarily drive pancreatic tumor progression.
Results: A literature review has been conducted and a link between chemical exposure and the impairment of salivary gland function, development of diabetes, obesity, and consequently pancreatic carcinogenesis has been proposed.

Conclusion: Pancreatic cancer risk is increased by several modifiable factors such as obesity or chemicals. These pollutants may induce type 2 diabetes perhaps as a consequence of altered tissue morphology and consequent pancreatic dysfunction. Salivary glands may also be targeted by any toxic substance that leads to the destruction of ductal cells or disrupts their function, thus impacting endocrine secretion and pancreatic regulation. Chemical exposure could also disrupt pancreatic morphogenesis and favor carcinogenesis. Future efforts should explore ways to avoid inflammatory processes and to promote anti-inflammatory reactions.

Keywords: Pancreatic cancer, Diabetes, Obesity, Inflammation, Chemical exposure, Salivary glands