Brian Z Huang1, Stephen J Pandol2, Christie Y Jeon3, Suresh T Chari4, Catherine A Sugar5, Chun R Chao6, Zuo-Feng Zhang7, Bechien U Wu8, Veronica Wendy Setiawan9. 1. Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California; Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California. Electronic address: brian.huang@kp.org. 2. Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center and Department of Veterans Affairs, Los Angeles, California. 3. Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California. 4. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota. 5. Department of Biostatistics, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California. 6. Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California. 7. Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California. 8. Center for Pancreatic Care, Division of Gastroenterology, Kaiser Permanente, Los Angeles, California. 9. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; Norris Comprehensive Cancer Center, Los Angeles, California.
Abstract
BACKGROUND & AIMS: Observational studies of predominantly white populations have found new-onset diabetes to be associated with increased risk of pancreatic cancer. We sought to determine whether this relationship applies to other races or ethnicities and to identify metabolic profiles associated with increased risk of pancreatic cancer. METHODS: We conducted a population-based cohort study of Asian, black, Hispanic and white patients from Kaiser Permanente Southern California from 2006 through 2016 (n = 1,499,627). Patients with diabetes were identified based on glucose and hemoglobin A1c (HbA1c) measurements. We used Cox regression to assess the relationship between diabetes status and duration and pancreatic cancer. For patients with recent diagnoses of diabetes (1 year or less) we compared longitudinal changes in glucose, HbA1c, and weight, from time of diabetes diagnosis through 3 years prior to the diagnosis, in patients with vs without pancreatic cancer. RESULTS: We identified 2,002 incident cases of pancreatic cancer from nearly 7.5 million person-years of follow-up. Compared to patients without diabetes, individuals who received a recent diagnosis of diabetes had an almost 7-fold increase in risk of pancreatic cancer (relative risk, 6.91; 95% CI, 5.76-8.30). Among patients with a recent diagnosis of diabetes, those who developed pancreatic cancer had more rapid increases in levels of glucose (Δslope: cases, 37.47 mg/dL vs non-cases, 27.68 mg/dL) and HbA1c (Δslope: cases, 1.39% vs non-cases, 0.86%) in the month preceding the diagnosis of diabetes, and subtle weight loss in the prior years (slope: cases -0.18 kg/interval vs non-cases 0.33 kg/interval). These longitudinal changes in markers of metabolism were stronger for specific race and ethnic groups. CONCLUSIONS: In a study of a large ethnically diverse population, we found risk of pancreatic cancer to be increased among patients with a diagnosis of diabetes in the past year among different races and ethnicities. Weight loss and rapid development of poor glycemic control were associated with increased risk of pancreatic cancer in multiple races.
BACKGROUND & AIMS: Observational studies of predominantly white populations have found new-onset diabetes to be associated with increased risk of pancreatic cancer. We sought to determine whether this relationship applies to other races or ethnicities and to identify metabolic profiles associated with increased risk of pancreatic cancer. METHODS: We conducted a population-based cohort study of Asian, black, Hispanic and white patients from Kaiser Permanente Southern California from 2006 through 2016 (n = 1,499,627). Patients with diabetes were identified based on glucose and hemoglobin A1c (HbA1c) measurements. We used Cox regression to assess the relationship between diabetes status and duration and pancreatic cancer. For patients with recent diagnoses of diabetes (1 year or less) we compared longitudinal changes in glucose, HbA1c, and weight, from time of diabetes diagnosis through 3 years prior to the diagnosis, in patients with vs without pancreatic cancer. RESULTS: We identified 2,002 incident cases of pancreatic cancer from nearly 7.5 million person-years of follow-up. Compared to patients without diabetes, individuals who received a recent diagnosis of diabetes had an almost 7-fold increase in risk of pancreatic cancer (relative risk, 6.91; 95% CI, 5.76-8.30). Among patients with a recent diagnosis of diabetes, those who developed pancreatic cancer had more rapid increases in levels of glucose (Δslope: cases, 37.47 mg/dL vs non-cases, 27.68 mg/dL) and HbA1c (Δslope: cases, 1.39% vs non-cases, 0.86%) in the month preceding the diagnosis of diabetes, and subtle weight loss in the prior years (slope: cases -0.18 kg/interval vs non-cases 0.33 kg/interval). These longitudinal changes in markers of metabolism were stronger for specific race and ethnic groups. CONCLUSIONS: In a study of a large ethnically diverse population, we found risk of pancreatic cancer to be increased among patients with a diagnosis of diabetes in the past year among different races and ethnicities. Weight loss and rapid development of poor glycemic control were associated with increased risk of pancreatic cancer in multiple races.
Authors: M Ducreux; A Sa Cuhna; C Caramella; A Hollebecque; P Burtin; D Goéré; T Seufferlein; K Haustermans; J L Van Laethem; T Conroy; D Arnold Journal: Ann Oncol Date: 2015-09 Impact factor: 32.976
Authors: Ben Boursi; Brian Finkelman; Bruce J Giantonio; Kevin Haynes; Anil K Rustgi; Andrew D Rhim; Ronac Mamtani; Yu-Xiao Yang Journal: Gastroenterology Date: 2016-12-05 Impact factor: 22.682
Authors: Mark C Hornbrook; Gene Hart; Jennifer L Ellis; Donald J Bachman; Gary Ansell; Sarah M Greene; Edward H Wagner; Roy Pardee; Mark M Schmidt; Ann Geiger; Amy L Butani; Terry Field; Hassan Fouayzi; Irina Miroshnik; Liyan Liu; Robert Diseker; Karen Wells; Rick Krajenta; Lois Lamerato; Christine Neslund Dudas Journal: J Natl Cancer Inst Monogr Date: 2005
Authors: Donghui Li; Hongwei Tang; Manal M Hassan; Elizabeth A Holly; Paige M Bracci; Debra T Silverman Journal: Cancer Causes Control Date: 2010-11-21 Impact factor: 2.506
Authors: Yunxia Lu; Luis Alberto García Rodríguez; Linnéa Malgerud; Antonio González-Pérez; Mar Martín-Pérez; Jesper Lagergren; Tomas S Bexelius Journal: Br J Cancer Date: 2015-11-17 Impact factor: 7.640
Authors: Barbara Kenner; Suresh T Chari; David Kelsen; David S Klimstra; Stephen J Pandol; Michael Rosenthal; Anil K Rustgi; James A Taylor; Adam Yala; Noura Abul-Husn; Dana K Andersen; David Bernstein; Søren Brunak; Marcia Irene Canto; Yonina C Eldar; Elliot K Fishman; Julie Fleshman; Vay Liang W Go; Jane M Holt; Bruce Field; Ann Goldberg; William Hoos; Christine Iacobuzio-Donahue; Debiao Li; Graham Lidgard; Anirban Maitra; Lynn M Matrisian; Sung Poblete; Laura Rothschild; Chris Sander; Lawrence H Schwartz; Uri Shalit; Sudhir Srivastava; Brian Wolpin Journal: Pancreas Date: 2021-03-01 Impact factor: 3.243
Authors: Christie Y Jeon; Sungjin Kim; Yu-Chen Lin; Harvey A Risch; Mark O Goodarzi; Teryl K Nuckols; Stephen J Freedland; Stephen J Pandol; Joseph R Pisegna Journal: Cancer Epidemiol Biomarkers Prev Date: 2021-11-02 Impact factor: 4.090
Authors: Bechien U Wu; Eva Lustigova; Qiaoling Chen; Elizabeth Y Dong; Anirban Maitra; Suresh T Chari; Ziding Feng; Jo Ann Rinaudo; Lynn M Matrisian; Rex A Parker Journal: Clin Transl Gastroenterol Date: 2022-06-01 Impact factor: 4.396