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Type 2 diabetes may be early expression of pancreatic cancer, 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.
The prevalence of diabetes among pancreatic cancer patients is unusually high relative to other cancers, 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 examined the association between recent-onset diabetes and pancreatic cancer in a prospective study of African Americans and Latinos, two minority populations with high diabetes risk. Questionnaires, Medicare data, and California hospital discharge files were used to identify new diabetes diagnoses. A total of 15, 833 (32.3 percent) participants developed diabetes between 1993 and 2013. A total of 408 incident pancreatic cancer cases were identified during follow-up.
During an average follow-up of 14 years, among those with diabetes, 128 participants developed pancreatic cancer. Among participants without diabetes, 280 participants developed pancreatic cancer. In pancreatic cancer with diabetes, 52.3 percent of cases developed diabetes in the 36 months preceding the pancreatic cancer diagnosis.
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.
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