Clinical epidemiological analysis of the relationship between pancreatic cancer and diabetes mellitus: Data from a single institution in China

Abstract

OBJECTIVE: To investigate the relationship between pancreatic cancer (PC) and diabetes mellitus. METHODS: All PC patients diagnosed and treated at Zhongshan hospital from January 1991 to December 2007 were retrospectively analyzed. During this period, 770 non‐digestive tract, non‐neoplastic and non‐hormone‐related patients matched for sex and age were collected as controls. The incidence of diabetes mellitus between the two groups was compared. RESULTS: Between the PC group and the control group, sex and age of the patients were well matched. The incidence of diabetes mellitus was 34.63% in the PC group and 8.83% in the control group (P < 0.001, RR = 5.19). In the PC group there was no correlation between age, sex, site of the cancer, tumor differentiation, lymph node metastasis, TNM staging and the incidence of diabetes mellitus. In this group with diabetes, 74.56% experienced onset within two years of cancer diagnosis. Of the control patients, 57.35% had had diabetes for under 2 years (P = 0.009, RR = 2.18). In the PC group with diabetes, 5.9% had had diabetes for more than 10 years while compared with 8.8% of the controls (P = 0.42). CONCLUSION: Whether diabetes mellitus is a result of or a risk factor for PC is still unclear. The incidence of diabetes mellitus is much higher in the PC patients. The onset of diabetes mellitus in adults might be an alerting factor that could lead to an early diagnosis of pancreatic cancer.

Elevated levels of CA 19-9 and CEA in pancreatic cancer-associated diabetes

“…The percentage of patients with jaundice and serum TBIL levels was significantly higher in PDA patients with diabetes than those without (40.0 vs. 23.1%; 8.54 ± 14.88 vs. 4.16 ± 6.12; P \ 0.05). However, there was no significant difference in tumor size, location, differentiation, TNM stage, hepatic metastasis between these two groups, which was consistent with the former reports (Kuang et al 2009;Pannala et al 2008). Similar to the results of Hb and ALT, there were no statistically significant differences in mean serum CEA and CA 19-9 level between PDA patients with or without diabetes.…”

“…In this study, we found that 25.6% of PDA patients met the diagnostic standard for diabetes, which was in line with the findings (22.8%) reported by Gullo et al (1994). Another data from a single institution in China demonstrated the incidence of diabetes was 34.63% (169/488) in pancreatic cancer (Kuang et al 2009). Nevertheless, the reported percentage of diabetes in pancreatic cancer varies greatly according to the methods and criteria used for the diagnosis of diabetes.…”

“…The present results were consistent with the reference in which diabetes was diagnosed either concomitantly with the cancer (in 40.2%), or within 2 years before the diagnosis of cancer (in 15.9%) (Gullo et al 1994). In addition, a research from China also showed more patients had diabetes (74.56%) within 2 years of pancreatic cancer diagnosis (Kuang et al 2009). Thus, combining our findings with the previous studies, diabetes is an early clinical situation of pancreatic cancer and should be given more attentions.…”

Diabetes and cancer I: risk, survival, and implications for screening

“…An exception is prostate cancer, for which diabetes appears protective [83, 84]. Studies demonstrating this association have been conducted across several different countries, including Italy [9, 26, 42], Sweden [3], Japan [35, 37, 40, 41, 61, 65], Scotland [66], the USA [7, 13, 14, 17, 20, 28, 36, 47, 48, 50, 55, 78–80], the UK [81], Turkey [11], China [8, 39], and New Zealand [24]. Information sources used to ascertain DM and cancer diagnoses in these international studies are quite diverse and include self-report in surveys and questionnaires; hospital discharge and admission records; well-defined long-term national longitudinal cohorts; documentation of fasting or postprandial glucose tests; medical records; and for cancer diagnosis, use of histological evaluation and cancer registry or death registry [3–80].…”

High risk factors of pancreatic carcinoma

“…Some epidemiological studies have excluded the possibility that long-standing DM is a risk factor for PC [96][97][98][99][100][101][102][103][104][105][106][107][108] , whereas others have found the otherwise [109][110][111][112][113][114][115][116] .…”