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Increased Risk of Pancreatic Malignancy in Diabetes

Posted: Saturday, April 23, 2011

The risk of pancreatic cancer is higher for diabetic patients.

Senior author Dr. Chung-Yi Li, National Cheng Kung University, stated, "That's not to say diabetics should be screened for these cancers." "These outcomes are rare even among diabetic patients." 

"Besides, screening of pancreatic neoplasm is difficult, because the presently available screening tests are not sensitive enough to detect small resectable neoplasms," Dr. Li added.

Dr. Li and colleagues used national health insurance data to investigate incidence rates and relative risks of pancreatic cancer in Taiwan's diabetic population between 2000 and 2006.

The analysis included 615,532 diabetic patients and 614,871 age- and sex-matched controls, according to a March 11 online report in Diabetes Care.

"Although we could not differentiate between Type 1 and Type 2 diabetes in our study, Type 1 diabetes constitutes only 1.8% of all diabetes in Taiwan," the researchers note. "Therefore, the majority of diabetic patients in our study are likely to be Type 2 diabetic patients."

The overall incidence of pancreatic malignancy per 10,000 patient-years was 3.34 for diabetic men and 2.58 for diabetic women, compared with 1.88 and 1.71 for men and women, respectively, in the control group.

The incidence increased with age among diabetics and controls, with the highest density in people over 65.

Overall, the risk of pancreatic malignancy was 66% higher in diabetic men and 43% higher in diabetic women than in gender-matched controls.

In the stratified analyses, the risk of pancreatic malignancy per 10,000 patient-years was significantly higher among diabetic men age 45 to 65 years (2.46 vs. 1.28, adjusted hazard ratio 1.91), diabetic men over age 65 years (3.71 vs. 2.66, aHR 1.47), diabetic women age 45 to 65 years (1.43 vs. 0.81, aHR 1.80), and diabetic women over age 65 years (3.23 vs. 2.62, aHR 1.26).

Differences in the under-45 age groups did not reach statistical significance.

It's not clear yet how Type 2 diabetes might cause pancreatic cancer. "Our previous studies found that diabetes is not only associated with increased risk for pancreatic cancer but also with other gastrointestinal and hepatobiliary cancers," Dr. Li said. "Further studies involving familial aggregation and metabolic factors behind these associations are warranted."

Source:, Diabetes Care March 11, 2011.

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