Original paper

Cancer Causes & Control

, Volume 24, Issue 1, pp 13-25

Diabetes and risk of pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium

  • Joanne W. ElenaAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human Services Email author 
  • , Emily SteplowskiAffiliated withInformation Management Services
  • , Kai YuAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services
  • , Patricia HartgeAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services
  • , Geoffrey S. TobiasAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services
  • , Michelle J. BrotzmanAffiliated withWestat, Inc
  • , Stephen J. ChanockAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesLaboratory of Translation Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesWestat, Inc
  • , Rachael Z. Stolzenberg-SolomonAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services
  • , Alan A. ArslanAffiliated withDepartment of Obstetrics and Gynecology, New York University School of MedicineDepartment of Environmental Medicine, New York University School of MedicineNew York University Cancer Institute
    • , H. Bas Bueno-de-MesquitaAffiliated withNational Institute for Public Health and the Environment (RIVM)Department of Gastroenterology and Hepatology, University Medical Center Utrecht
    • , Kathy HelzlsouerAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesPrevention and Research Center, Mercy Medical Center
    • , Eric J. JacobsAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesEpidemiology Research Program, American Cancer Society
    • , Andrea LaCroixAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesFred Hutchinson Cancer Research Center
    • , Gloria PetersenAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesDepartment of Health Sciences Research, Mayo Clinic
    • , Wei ZhengAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesDivision of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, and Vanderbilt-Ingram Cancer Center, Vanderbilt University
    • , Demetrius AlbanesAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services
    • , Naomi E. AllenAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesCancer Epidemiology Unit, University of Oxford, Nuffield Department of Clinical Medicine
    • , Laufey AmundadottirAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesLaboratory of Translation Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesWestat, Inc
    • , Ying BaoAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesChanning Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School
    • , Heiner BoeingAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesGerman Institute of Human Nutrition Potsdam-Rehbrüecke
    • , Marie-Christine Boutron-RuaultAffiliated withInformation Management ServicesInserm, (Institut National de la Santé et de la Recherche Médicale) and Institut Gustave Roussy
    • , Julie E. BuringAffiliated withInformation Management ServicesDivisions of Preventive Medicine and Aging, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical SchoolDepartment of Ambulatory Care and Prevention, Harvard Medical School
    • , J. Michael GazianoAffiliated withInformation Management ServicesPhysicians’ Health Study, Divisions of Aging, Cardiovascular Medicine, and Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical SchoolMassachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System
    • , Edward L. GiovannucciAffiliated withInformation Management ServicesDepartment of Epidemiology, Harvard School of Public HealthDepartment of Biostatistics, Harvard School of Public HealthDepartment of Nutrition, Harvard School of Public Health
    • , Eric J. DuellAffiliated withInformation Management ServicesUnit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL)
    • , Göran HallmansAffiliated withInformation Management ServicesDepartment of Public Health and Clinical Medicine, Nutritional Research, Umeå University
    • , Barbara V. HowardAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesMedStar Health Research Institute, Georgetown University
    • , David J. HunterAffiliated withInformation Management ServicesDepartment of Epidemiology, Harvard School of Public HealthDepartment of Biostatistics, Harvard School of Public Health
    • , Amy HutchinsonAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesLaboratory of Translation Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesWestat, IncCore Genotyping Facility, SAIC-Frederick Inc., NCI-Frederick
    • , Kevin B. JacobsAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services
    • , Charles KooperbergAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesFred Hutchinson Cancer Research Center
    • , Peter KraftAffiliated withInformation Management ServicesDepartment of Epidemiology, Harvard School of Public Health
    • , Julie B. MendelsohnAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services
    • , Dominique S. MichaudAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesDivision of Biology and Medicine, Brown UniversityDivision of Epidemiology, Public Health and Primary Care, Imperial College
    • , Domenico PalliAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesMolecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute–ISPO
    • , Lawrence S. PhillipsAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesDivision of Endocrinology, Emory UniversityAtlanta VA Medical Center
    • , Kim OvervadAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesDepartment of Epidemiology, School of Public Health, Aarhus University
    • , Alpa V. PatelAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesEpidemiology Research Program, American Cancer Society
    • , Leah SansburyAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesDepartment of Epidemiology, GlaxoSmithKline
    • , Xiao-Ou ShuAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesDivision of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, and Vanderbilt-Ingram Cancer Center, Vanderbilt University
    • , Michael S. SimonAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesKarmanos Cancer Institute, Department of Oncology, Wayne State University
    • , Nadia SlimaniAffiliated withWestat, IncInternational Agency for Research on Cancer
    • , Dimitrios TrichopoulosAffiliated withInformation Management ServicesWestat, IncDepartment of Epidemiology, Harvard School of Public HealthBureau of Epidemiologic Research, Academy of Athens
    • , Kala VisvanathanAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthJohns Hopkins Sidney Kimmel Comprehensive Cancer Center
    • , Jarmo VirtamoAffiliated withWestat, IncDepartment of Chronic Disease Prevention, National Institute for Health and Welfare
    • , Brian M. WolpinAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesWestat, IncChanning Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical SchoolDepartment of Medical Oncology, Dana-Farber Cancer Institute
    • , Anne Zeleniuch-JacquotteAffiliated withDepartment of Environmental Medicine, New York University School of MedicineNew York University Cancer Institute
    • , Charles S. FuchsAffiliated withDivision of Cancer Control and Population Science (DCCPS), National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesWestat, IncChanning Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical SchoolDepartment of Medical Oncology, Dana-Farber Cancer Institute
    • , Robert N. HooverAffiliated withDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services
    • , Myron GrossAffiliated withWestat, IncDepartment of Laboratory Medicine/Pathology, School of Medicine, University of Minnesota

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Abstract

Purpose

Diabetes is a suspected risk factor for pancreatic cancer, but questions remain about whether it is a risk factor or a result of the disease. This study prospectively examined the association between diabetes and the risk of pancreatic adenocarcinoma in pooled data from the NCI pancreatic cancer cohort consortium (PanScan).

Methods

The pooled data included 1,621 pancreatic adenocarcinoma cases and 1,719 matched controls from twelve cohorts using a nested case–control study design. Subjects who were diagnosed with diabetes near the time (<2 years) of pancreatic cancer diagnosis were excluded from all analyses. All analyses were adjusted for age, race, gender, study, alcohol use, smoking, BMI, and family history of pancreatic cancer.

Results

Self-reported diabetes was associated with a forty percent increased risk of pancreatic cancer (OR = 1.40, 95 % CI: 1.07, 1.84). The association differed by duration of diabetes; risk was highest for those with a duration of 2–8 years (OR = 1.79, 95 % CI: 1.25, 2.55); there was no association for those with 9+ years of diabetes (OR = 1.02, 95 % CI: 0.68, 1.52).

Conclusions

These findings provide support for a relationship between diabetes and pancreatic cancer risk. The absence of association in those with the longest duration of diabetes may reflect hypoinsulinemia and warrants further investigation.

Keywords

Diabetes Risk factor Cohort consortium Pancreatic cancer