Effect of Gender on Pancreatic Disease

This chapter discusses pancreatic lesions that occur more frequently in men or women, evaluates the mechanisms by which they occur, and reviews their clinical course and therapy. Sex steroid hormones (SSH) including estrogens, progestagens, and androgens are responsible for sexual differentiation, and their major target organs are the mammary glands, urogenital tract, bone, cardiovascular and central nervous systems. Epidemiologic, clinical, and biochemical findings have shown the relationship between gender and prevalence of some tumors of the pancreas, the effect of pregnancy on insulin and glucose metabolism, and the identification of SSH receptors in pancreatic tissue. The study of gender-specific pancreatic lesions provides clues regarding their origin, development, tumoral behavior, prognosis, and more specific hormonal therapy. The varying effects of sex steroid hormones (SSH) in development and growth of pancreatic neoplasms may be related to the mechanism affecting carcinogenesis, and may be multifactorial and/or different for each hormone. Clinical trials designed to evaluate the response of cancer of the pancreas to hormonal therapy have been inconclusive.