Does New-Onset Diabetes Predict Pancreatic Cancer?

In a new study, researchers suggest that individuals with new-onset diabetes should be considered at high risk for pancreatic cancer and proactively screened for the diseases.

“Pancreatic cancer is a highly lethal cancer that is increasing in incidence. Although rates of cancer-related deaths from most cancer types have fallen over the past decades due to better prevention, diagnosis, and treatment, pancreatic cancer has remained a major cause of cancer-related death,” wrote Natalia Khalaf and Basim Ali, the researchers who set out to establish the connection between diabetes and pancreatic cancer. Their research was published in Clinical Gastroenterology and Hepatology.

The need to find strategies for early diagnosis stems from the lack of information around identifying pancreatic cancer. Markers of early-stage disease can lead to earlier cancer diagnosis, the authors noted, observing that “pancreatic cancer is the only cancer without a clear, systematic approach to early diagnosis.”

Between 1975 and 2016, the incidence rates of pancreatic cancer have continually risen annually by 0.78%. At this rate, it is projected to become the second-leading cause of cancer-related death by 2030.

The investigators found a strong association between new-onset diabetes after age 50 and pancreatic cancer. “Data show that in patients who develop diabetes at or after age 50, the 3-year pancreatic cancer incidence rate after diabetes diagnosis is 0.8% to 1.0%, 6- to 10-fold higher than that of the general population.”

They also found that when most patients developed hyperglycemia, they also developed signs for early-stage pancreatic cancer at the same time or within 6-18 months later. These findings have prompted the U.S. Preventive Services Task Force to recognize patients with new-onset diabetes at age 50 and older to be termed as “a high-risk group for sporadic pancreatic cancer.”

—Priyam Vora

Reference:

Khalaf N, Ali B. New-onset diabetes as a signpost of early pancreatic cancer: The role of screening. Clin Gastroenterol Hepatol. 2022; 20(9): 1927-1930. DOI: https://doi.org/10.1016/j.cgh.2022.02.015