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Risk factors and early signs of pancreatic cancer in diabetes: screening strategy based on diabetes onset age
Journal of Gastroenterology, 07/10/2012

Mizuno S et al. – The study revealed specific risk factors for and similar early signs of pancreatic cancer (PaC) in early–onset and late–onset Diabetes mellitus (DM). Thus, the authors could develop a screening strategy, combining these risk factors specific for DM–onset age with early signs of disease.

Methods
  • Forty diabetic patients with PaC were identified and compared with 120 diabetic patients without any malignancies.
  • The authors analyzed risk factors for and early signs of PaC, focusing on the DM-onset age.

Results
  • As there were peaks at 40–45 years and 60–65 years in the distribution of DM-onset age, they analyzed the clinical characteristics of and risk factors for PaC according to DM-onset age: i.e., early-onset (<55 years) and late-onset (≥55 years).
  • PaC was diagnosed within 2 years of DM onset (new-onset) in 0 % of the patients with early-onset DM, and in 33 % of those with late-onset DM.
  • The mean duration of DM in patients with early-onset DM with PaC was longer than that in the late-onset patients (26 vs. 9 years; P < 0.01).
  • A family history of DM (odds ratio [OR] 3.60) and use of insulin (OR 3.52) were significant risk factors in patients with early-onset DM, while the onset age of DM (OR 1.12) and multiple diabetic patients in the family (OR 6.13) were risk factors in those with late-onset DM.
  • Body weight loss and exacerbation of DM were seen 12 months prior to PaC diagnosis in both groups.

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