Diabetes may be an early manifestation of pancreatic cancer

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A new study in the Journal of the National Cancer Institute, published by Oxford University Press, indicates that recent-onset type 2 diabetes may be early expression of pancreatic cancer. Diabetes was associated with a more than twofold higher risk of pancreatic cancer in African Americans and Latinos, but recent-onset diabetes was associated with a 2.3-fold greater increase in risk of pancreatic cancer than long-standing diabetes.

            Pancreatic cancer is one of the most fatal cancers, with a five-year survival rate of only 8 percent. This is because the vast majority of pancreatic cancer patients (some 80 percent of them) are diagnosed at a late stage. Identification of high-risk people and ability to detect pancreatic cancer earlier would likely improve patient outcomes.

Diabetes has been consistently associated with pancreatic cancer in previous studies, with a twofold higher risk of developing pancreatic cancer among diabetes patients. Diabetes has been proposed to be both a risk factor for and a consequence of pancreatic cancer. The prevalence of diabetes among pancreatic cancer patients is unusually high relative to other cancers.

The majority of the diabetes patients with pancreatic cancer are diagnosed with diabetes less than three years before the cancer diagnosis. Among pancreatic cancer patients undergoing pancreaticoduodenectomies (the surgical operation often used to try to remove pancreatic tumors), over half of patients with recent-onset diabetes have no diabetes postoperatively. Researchers have observed no effect in those who have had diabetes for more than three years.

             Recent-onset diabetes was strikingly higher among pancreatic cancer cases (16.4 percent) compared with those with colorectal (6.7 percent), breast (5.3 percent), and prostate (5.5 percent) cancer.Diabetes was associated with an approximately twofold increased risk of pancreatic cancer. When stratifying by disease duration, people with recent-onset diabetes had the highest risk of developing pancreatic cancer. Importantly, the researchers demonstrated that the association of recent-onset diabetes with pancreatic cancer incidence was evident in African Americans and Latinos, two understudied minority populations with high risk of diabetes but different pancreatic cancer rates.