Recent progress in pancreatic cancer (original) (raw)
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Diabetes mellitus, other medical conditions and pancreatic cancer: a case-control study
Diabetes/Metabolism Research and Reviews, 2011
Diabetes and other medical conditions have been related to pancreatic cancer, but time risk quantification is unsettled. We combined data from two case-control studies conducted in Italy, including 688 pancreatic cancer cases and 2204 controls. All subjects were interviewed by trained interviewers during their hospital stay. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using multiple logistic regression. Overall, 103 cases (15%) and 125 controls (5.7%) reported a history of diabetes. The OR for pancreatic cancer was more pronounced among those diagnosed with diabetes in the previous 2 years (OR = 5.17; 95% CI = 2.71-9.87) than among those with diabetes diagnosed more than 2 years ago (OR = 2.35; 95% CI = 1.70-3.26). The ORs remained significantly elevated 2-4 years (OR = 3.81; 95% CI = 2.07-7.04) and 5-9 years (OR = 3.75; 95% CI = 2.13-6.59) since diagnosis of diabetes, after which a non-significant 20% increased risk for pancreatic cancer was observed. As compared to non-diabetic non-smokers, the OR was 1.85 among non-diabetic current smokers, 2.17 among diabetic never/former smokers, and rose to 4.67 among diabetic current smokers, indicating a multiplicative effect between these two risk factors. Pancreatic cancer was significantly associated with pancreatitis, primarily among those diagnosed within 2 years (OR = 7.16; 95% CI = 2.25-22.78). In addition, the ORs were elevated for cholelithiasis (3.53; 95% CI = 1.67-7.45) and gastroduodenal ulcer (3.16; 95% CI = 1.14-8.73) only among those diagnosed within the past 2 years. Diabetes is associated with heightened risk of pancreatic cancer. The association is significant for diabetes diagnosed up to 10 years before pancreatic cancer.
Diabetes and pancreatic cancer
BMJ, 1988
Epidemiological studies clearly indicate that the risk of pancreatic cancer (PC) is increased in diabetic patients, but most studies focus on overall diabetes or type 2 diabetes mellitus (T2DM), and there are few studies on the risks of type 1 and type 3c (secondary) diabetes. Possible mechanisms for increased cancer risk in diabetes include cellular proliferative effects of hyperglycemia, hyperinsulinemia, and abnormalities in insulin/IGF receptor pathways. Recently, insulin and insulin secretagogues have been observed to increase the PC risk, while metformin treatment reduces the cancer risk in diabetic subjects. In addition, anticancer drugs used to treat PC may either cause diabetes or worsen coexisting diabetes. T3cDM has emerged as a major subset of diabetes and may have the highest risk of pancreatic carcinoma especially in patients with chronic pancreatitis. T3cDM is also a consequence of PC in at least 30% of patients. Distinguishing T3cDM from the more prevalent T2DM among new-onset diabetic patients can be aided by an assessment of clinical features and confirmed by finding a deficiency in postprandial pancreatic polypeptide release. In conclusion, diabetes and PC have a complex relationship that requires more clinical attention. The risk of developing PC can be reduced by aggressive prevention and treatment of T2DM and obesity and the prompt diagnosis of T3cDM may allow detection of a tumor at a potentially curable stage.
Newly diagnosed type 2 diabetes may serve as a potential marker for pancreatic cancer
Diabetes/metabolism research and reviews, 2018
Pancreatic cancer has an extremely highly case fatality. Diabetes is a well-established strong risk factor for pancreatic cancer. Compared with a nondiabetic population, we previously reported a 15- and 14-fold greater risk for detecting pancreatic cancer during the first year after diagnosing diabetes in adult women and men, respectively, which dropped during the second year to 5.4-fold and 3.5-fold, respectively, and stabilized around 3-fold for the rest of the 11-year follow-up in our historical cohort. The population attributable risk during the 11-year period was 13.3% and 14.1% in prevalent diabetic women and men, respectively. This means that one out of about every 8 patients diagnosed with pancreatic cancer has been previously diagnosed with diabetes. The globally high prevalence of diabetes and the aggravating implications of a delayed pancreatic cancer diagnosis call for newly-onset diabetes to be considered a potential marker for an underlying pancreatic cancer and addres...
Cancer Causes & Control, 2013
Diabetes is a suspected risk factor for pancreatic cancer, but questions remain about whether it is a risk factor or a result of the disease. This study prospectively examined the association between diabetes and the risk of pancreatic adenocarcinoma in pooled data from the NCI pancreatic cancer cohort consortium (PanScan). The pooled data included 1,621 pancreatic adenocarcinoma cases and 1,719 matched controls from twelve cohorts using a nested case-control study design. Subjects who were diagnosed with diabetes near the time (<2 years) of pancreatic cancer diagnosis were excluded from all analyses. All analyses were adjusted for age, race, gender, study, alcohol use, smoking, BMI, and family history of pancreatic cancer. Self-reported diabetes was associated with a forty percent increased risk of pancreatic cancer (OR = 1.40, 95 % CI: 1.07, 1.84). The association differed by duration of diabetes; risk was highest for those with a duration of 2-8 years (OR = 1.79, 95 % CI: 1.25, 2.55); there was no association for those with 9+ years of diabetes (OR = 1.02, 95 % CI: 0.68, 1.52). These findings provide support for a relationship between diabetes and pancreatic cancer risk. The absence of association in those with the longest duration of diabetes may reflect hypoinsulinemia and warrants further investigation.
Association between Diabetes Mellitus and Pancreatic Cancer: A Comprehensive Narrative Review
Journal of Medical and Health Studies
Pancreatic cancer (PC) is extremely aggressive, with symptoms occurring only in the advanced stage. The relationship between Type 2 Diabetes Mellitus (T2DM) and PC is complex. However, it is unclear whether long-standing diabetes causes cancer or whether cancer proceeds the development of impaired glucose metabolism. PubMed, Google Scholar, Scopus and Cochrane library were consulted to look for relevant literature. We narrowed down 20 articles after implementing inclusion and exclusion criteria. The database was searched using the keywords “Pancreatic Cancer” AND “Diabetes Mellitus.” This narrative literature review aims to analyze the literature on the analysis of the metabolic association of T2DM, the risk of carcinogenesis of the pancreas and their association, and the current understanding of metabolic pathways involved in cellular growth and metabolism. About 80% of patients with pancreatic disease have a previous diagnosis of diabetes within five years. We explored the literat...
2022
Review question / Objective: Which additional risk factors raise the incidence of pancreatic cancer in the population of new onset diabetics? Condition being studied: Pancreatic cancer, new onset diabetes. Eligibility criteria: Inclusion criteria are:• English abstract available• The population of newly onset diabetics is examined, at least as a subgroup. Newly diagnosed is defined as onset of maximal 3 years ago.• Information on other risk factors of patients is available in the study.
The relationship between diabetes and pancreatic cancer
Molecular cancer, 2003
About 80% of pancreatic cancer patients have glucose intolerance or frank diabetes. This observation has led to the following two hypotheses: i. pancreatic cancer causes the associated diabetes and ii. the conditions associated with diabetes promote the development of pancreatic cancer. Evidence supporting both hypotheses has been accumulated in previous studies. This article reviews these studies, especially those that have been conducted recently.
Diabetes Could Be a Warning Sign of Pancreatic Cancer: A Case Report and Literature Review
International journal of gastroenterology, 2020
Pancreatic cancer (PC) is 1 of the deadliest cancers, representing the fourth leading cause of cancer death in the world; This high mortality is due to late symptom onset and because most of the cases of pancreatic cancer are stage IV at diagnosis, and hence not a candidate for curative resection. The following report will serve to emphasize the role of new-onset diabetes in certain patients as a warning sign necessitating further investigation for pancreatic cancer. It' s about a 46-years old man was admitted in hospital «service of forensic and penitentiary medicine » for jaundice associated with progressive asthenia, abdominal pain, and weight loss. He had been diagnosed with diabetes 4 weeks earlier by his GP. Despite lifestyle changes, he had been commenced on metformin after just 2 weeks due to poor glycaemic control. Physical examination showed a mass of the upper right quadrant on palpation. Computed tomography of the abdomen showing a solid mass of 55 mm in the head of the pancreas, hypodense in particular, with mild Wirsung and bile ducts dilatation, and the focal thrombi is found at the level of the 9 mm splenomersaraic confluent, with hepatic secondary localization images. He was subsequently diagnosed with new-onset diabetes and metastatic pancreatic cancer. The treatment with basal insulin / bolus and anticoagulant therapy was instituted and after stabilization; the patient has been oriented for bilio-pancreatic derivation, and eventual biopsy in a specialized center, but unfortunately the patient died only a few weeks after. PC occurs with increased frequency in patients with type 2 diabetes mellitus (DM2) which is considered the third modifiable risk factor for pancreatic cancer after cigarette smoking and obesity. Although numerous studies have linked both entities since 1833 the mechanism behind this association are complex and not well understood by the moment.