Which factor is most associated with an increased risk of pancreatic cancer?

• A. Smoking
• B. Type 1 diabetes
• C. Obesity
• D. Pancreatitis

Answer: (A)

The main concept here is identifying factors that increase the likelihood of pancreatic cancer, with a focus on which factor has the strongest association. Smoking stands out because tobacco contains carcinogens that reach the pancreas and promote malignant changes in cells. Epidemiologic studies show that current smokers have roughly two to three times the risk of developing pancreatic cancer compared with nonsmokers, and the risk climbs with the amount smoked and the duration of smoking. Quitting can lower risk over time, but it does not immediately return to the baseline level.

Other factors listed do contribute to risk, but not as strongly. Type 1 diabetes isn’t as clearly linked as type 2 diabetes, obesity does increase risk but to a lesser extent, and chronic pancreatitis is a known risk factor due to ongoing inflammation. Among these options, smoking has the strongest and most consistent association with pancreatic cancer.