Pancreatic Cancer–Associated Diabetes Mellitus: Prevalence and Temporal Association With Diagnosis of Cancer

Chari, Suresh T.; Leibson, Cynthia L.; Rabe, Kari G.; Timmons, Lawrence J.; Ransom, Jeanine E.; Andrade, Mariza de; Petersen, Gloria M.

doi:10.1053/j.gastro.2007.10.040

Cited by 435 publications

(354 citation statements)

References 30 publications

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“…A recent meta-analysis demonstrated that individuals with new-onset (< 4 years) DM had a 50% greater risk of PaC as compared with individuals who had had DM for > 5 years (OR 2.1 vs. 1.5, P=0.005) (9). Several studies have noted that DM is prevalent even in early-stage PaC (8,10). Our prospective study has demonstrated that the incidence of PaC among newly diagnosed T2DM patients is 198.6-fold higher than in the normal population.…”

Section: Discussionmentioning

confidence: 99%

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New-onset type 2 diabetes mellitus – A high-risk group suitable for the screening of pancreatic cancer?

et al. 2016

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2Background: Type 2 diabetes mellitus is widely considered to be associated with pancreatic cancer.Objective: To determine the incidence of pancreatic cancer in new-onset type 2 diabetic patients by measuring the serum level of CA 19-9 and performing abdominal ultrasonography (US). Patients and Methods:Consecutive type 2 diabetic patients in whom diabetes was diagnosed within 36 months were included in this prospective study. Serum CA 19-9 measurement and US were performed in all patients. If any of two was positive, abdominal computer tomography (CT) was carried out. Endoscopic ultrasound-guided fine needle aspiration or direct surgical referral was performed on patients with CT-identified lesions.Results: A total of 115 patients were enrolled. CA 19-9 was elevated in 10 patients but pancreatic cancer diagnosed in neither of them. Pancreatic cancer was revealed by morphological means in three patients without elevated CA 19-9 level. The sensitivity, specificity, positive-, negative predictive values and validity were 0%, 90.4%, 0%, 97.9% and 87.9% for CA 19-9, 66.7%, 100%, 100%, 99% and 99% for US, respectively. The value of the Standardized Incidence Ratio for pancreatic cancer in new-onset type-2 diabetic patients was 198.6 (95% CI=6.25-46.9). Conclusions:The prevalence of pancreatic cancer in patients with new-onset type-2 diabetes is significantly higher than that in the general population and screening is beneficial for detecting PaC in this patient population. CA 19-9 and US is not reliable screening modality for pancreatic cancer screening in this population.

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Section: Discussionmentioning

confidence: 99%

“…The prevalence of type 2 diabetes mellitus (T2DM) in PaC patients has been reported to be 40%, and 50% of T2DM patients with PaC have T2DM with a duration of 2 years or less (8).…”

Section: Introductionmentioning

confidence: 99%

New-onset type 2 diabetes mellitus – A high-risk group suitable for the screening of pancreatic cancer?

et al. 2016

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“…Diabetes is present in 34-40% of patients with pancreatic cancer, and it has often been diagnosed only in these patients (7). Long-term diabetes is considered to be one of the pathogenic factors of pancreatic cancer, and a recent onset of diabetes may be a manifestation of the cancer (8).…”

Section: Factors Associated With Neural Invasion Of Pancreatic Carcinomamentioning

confidence: 99%

The concept and controversy of retroperitoneal nerve dissection in pancreatic head carcinoma (Review)

Wang

Zhang

Wang

et al. 2015

International Journal of Oncology

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Abstract. Pancreatic head cancer is a common but the most lethal cancer of the human digestive system. It is invasive, resulting in early infiltration of adjacent structures and lymph node and distant metastases. Its biological characteristics of neurotropic growth lead to early neural invasion (NI) which is an independent prognostic factor of survival for pancreatic cancer. Radical surgical resection remains the only form of curative treatment. The extent of surgical resection and whether extended resection results in better long-term survival have been controversial. Studies have reported that peripancreatic plexus invasion is a frequent cause of pancreatic cancer recurrence and death. The relationship between cancer microenvironment and nerve cells, and whether the peripancreatic nerve plexus nearby needs to be resected require further studies. The present review aims to discuss the role of peripancreatic nerve and its implications in pancreatic head cancer resection.

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“…In particular, only cigarette smoking 9 and family history 10 of this neoplasia are well-known risk factors for PAC. Furthermore, heavy fat intake in the diet, 11 alcohol abuse, 12 as well as history of diabetes mellitus 13 and chronic pancreatitis 14 have been associated with a higher incidence of PAC.…”

Section: Introductionmentioning

confidence: 99%

Pancreatic carcinoma development: new etiological and pathogenetic evidence

Fiorino¹,

Reggiani

Pontoriero

et al. 2013

Ital J Med

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Pancreatic adenocarcinoma (PAC) is a very aggressive cancer with a poor prognosis. To date, the causes and pathogenetic mechanisms involved in the development of this malignancy remain largely unknown. Therefore, additional studies are required to improve our knowledge of the events that occur during the process of pancreatic carcinogenesis. The purpose of this article is to describe the most recent evidence, concerning the possible risk factors and mechanisms that may contribute to determine the development of PAC, as well as models, such as the tensegrity model, that may explain this complex process. Available studies suggest that approximately 15-20% of human malignancies are somehow associated with chronic infection. Some epidemiological research has shown that some infectious agents represent risk factors for PAC. In particular, several reports showed that the infection caused by some micro-organisms, including helicobacter pylori and some bacterial species of oral microbiota, as well as by viral agents, such as human immunodeficiency virus (HIV), and hepatitis B (HBV) and C (HCV) viruses, is associated with an increased probability of developing PAC. For the first time, observational studies and meta-analyses have suggested that HBV and HCV, two hepatotropic viruses with oncogenic properties, may be also risk factors for PAC. However, the small number of available reports, nearly all performed in Asian populations, limits their validity to these ethnic groups. Therefore, additional studies focusing on populations of different geographical areas and enrolling larger series of patients are required to confirm this association. Furthermore, an accurate description and a better understanding of the events and of the pathogenetic mechanisms involved in the process of pancreatic carcinogenesis, as proposed by the tensegrity model, might be a useful approach to effectively deal with this pathology.

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Pancreatic Cancer–Associated Diabetes Mellitus: Prevalence and Temporal Association With Diagnosis of Cancer

Abstract: Background/Aims-The temporal association between diabetes mellitus and pancreatic cancer is poorly understood. We compared temporal patterns in diabetes prevalence in pancreatic cancer and controls.

Cited by 435 publications

References 30 publications

New-onset type 2 diabetes mellitus – A high-risk group suitable for the screening of pancreatic cancer?

New-onset type 2 diabetes mellitus – A high-risk group suitable for the screening of pancreatic cancer?

The concept and controversy of retroperitoneal nerve dissection in pancreatic head carcinoma (Review)

Pancreatic carcinoma development: new etiological and pathogenetic evidence

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