Diabetes, Weight Change, and Pancreatic Cancer Risk

Abstract

IMPORTANCEPancreatic cancer is the third-leading cause of cancer death in the United States; however, few high-risk groups have been identified to facilitate early diagnosis strategies.OBJECTIVE To evaluate the association of diabetes duration and recent weight change with subsequent risk of pancreatic cancer in the general population. DESIGN, SETTING, AND PARTICIPANTSThis cohort study obtained data from female participants in the Nurses' Health Study and male participants in the Health Professionals Follow-Up Study, with repeated exposure assessments over 30 years. Incident cases of pancreatic cancer were identified from self-report or during follow-up of participant deaths. Deaths were ascertained through reports from the next of kin, the US Postal Service, or the

Pancreatic cancer risk predicted from disease trajectories using deep learning

“…It is, however, interesting to compare the features learned by the neural network system with known risk factors or diagnostic indicators. For example, type II diabetes (non-insulin-dependent), obesity, weight loss or jaundice ranked high in the feature list as important risk factors ( Figure 4 ), consistent with the epidemiological studies (Yuan et al 2020; Klein et al 2013; Kim et al 2020) and the observed disease distribution in the DNPR dataset ( Figure S3 ). Other factors, such as cholelithiasis (gallstones) and reflux disease, are perhaps of interest in terms of potential mechanistic hypotheses, such as inflammation of the pancreas as a results of cholelithiasis (gallstones) or a potential link between medication by proton pump inhibitors such as omeprazole in reflux disease (Kearns, Boursi, and Yang 2017; Lai 2021).…”

“…One method computationally infers the contribution of a particular input variable on the accuracy of prediction. The other method uses prior knowledge and limits the input to disease types, which have been reported to be indicative of the likely occurrence of pancreatic cancer (Yuan et al 2020; Klein 2021). These prior-knowledge diseases are somewhat predictive of cancer but are less informative compared to the more than 2,000 available diseases ( Table S4 , Figure 3E ).…”

Diabetes and pancreatic cancer: Exploring the two-way traffic

“…The increased risk of PC in long-standing T2DM has been suggested across different population of the world, including Asians[ 8 - 10 ]. A recent report involving a large population ( n = 112818 females and 46207 males respectively) over 30 years of cumulative exposure showed an increased risk of PDAC with long-standing diabetes over time (age-adjusted hazard ratio [HR] 2.16 [95%CI: 1.78-2.60])[ 11 ]. Another recently published meta-analysis also suggested an increased PC related mortality with T2DM (relative risk [RR] 1.67; [95%CI: 1.30-2.14])[ 12 ].…”

“…Olson and colleagues showed that NOD and severe weight loss often occurred together before the diagnosis of PC[ 90 ]. Chen et al [ 11 ] observed that in a subject with NOD, when weight loss was unintentional or occurred in an individual with body mass index (BMI) less than 25 kg/m 2 , then it substantially increased the risk of PC. Hence, weight change should be actively sought in elderly diabetes and warrant further investigation for PC.…”

ASO Author Reflections: Prediagnosis Weight Loss: Early Detection and Postoperative Prognosis Among Patients with Pancreatic Cancer

“…Past studies examining weight loss and pancreatic cancer are often limited by small sample sizes, use of subjective weight data, or extended time intervals between measurements. 3…”