TPW 6.08 The Role of Micronutrients in the Development of Pancreatic Cancer: A Narrative Review

Abstract

Pancreatic cancer has a poor prognosis and limited modifiable risk factors. Micronutrients may influence pancreatic carcinogenesis through antioxidant, metabolic, and epigenetic mechanisms. This narrative review aimed to synthesise contemporary epidemiological evidence on the association between key dietary micronutrients and pancreatic cancer risk. A literature search was conducted using PubMed, MEDLINE, and Embase, in 2022, March 2024 and August 2025. Primary observational studies examining dietary intake or circulating levels of selected vitamins (A, B6, B9, B12, C, D, and E) and minerals (iron, magnesium, selenium, and zinc) in relation to pancreatic cancer were included. Preclinical studies, reviews, and meta-analyses were excluded. Evidence was synthesised without quantitative pooling. Seventy-three studies were included. Overall, findings were heterogeneous across micronutrients, study designs, and exposure assessment methods. Dietary intake of most micronutrients, including vitamin A, vitamin D, zinc, iron, and vitamin B12, was not consistently associated with pancreatic cancer risk. More frequent inverse associations were reported for vitamin C, vitamin E, selenium, folate, vitamin B6, and magnesium, particularly in case–control studies and biomarker-based analyses. Prospective cohort studies generally reported weaker or null associations. Associations for circulating micronutrient concentrations were often stronger but inconsistent. Current epidemiological evidence does not support strong or consistent associations between most individual micronutrients and pancreatic cancer risk. Modest protective associations for magnesium, folate, and vitamin B6 warrant further investigation. Future large prospective studies with repeated dietary and biomarker assessments are needed to clarify causality and sort micronutrient-specific effects from broader dietary and metabolic patterns.