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Risk factors and early signs of pancreatic cancer in diabetes: screening strategy based on diabetes onset age

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Diabetes mellitus (DM) has long been recognized as a risk factor for pancreatic cancer (PaC) and recently has attracted attention as a manifestation of PaC. Diabetes is expected to be a clue for the early detection of PaC; however, no effective screening strategy has been established.

Methods

Forty diabetic patients with PaC were identified and compared with 120 diabetic patients without any malignancies. We analyzed risk factors for and early signs of PaC, focusing on the DM-onset age.

Results

As there were peaks at 40–45 years and 60–65 years in the distribution of DM-onset age, we analyzed the clinical characteristics of and risk factors for PaC according to DM-onset age: i.e., early-onset (<55 years) and late-onset (≥55 years). PaC was diagnosed within 2 years of DM onset (new-onset) in 0 % of the patients with early-onset DM, and in 33 % of those with late-onset DM. The mean duration of DM in patients with early-onset DM with PaC was longer than that in the late-onset patients (26 vs. 9 years; P < 0.01). A family history of DM (odds ratio [OR] 3.60) and use of insulin (OR 3.52) were significant risk factors in patients with early-onset DM, while the onset age of DM (OR 1.12) and multiple diabetic patients in the family (OR 6.13) were risk factors in those with late-onset DM. Body weight loss and exacerbation of DM were seen 12 months prior to PaC diagnosis in both groups.

Conclusions

Our study revealed specific risk factors for and similar early signs of PaC in early-onset and late-onset DM. Thus, we could develop a screening strategy, combining these risk factors specific for DM-onset age with early signs of disease.

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Conflict of interest

The authors declare that they have no conflict of interest

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Authors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan

    Suguru Mizuno, Yousuke Nakai, Hiroyuki Isayama, Naminatsu Takahara, Koji Miyabayashi, Keisuke Yamamoto, Kazumichi Kawakubo, Dai Mohri, Hirofumi Kogure, Takashi Sasaki, Natsuyo Yamamoto, Naoki Sasahira, Kenji Hirano, Takeshi Tsujino, Hideaki Ijichi, Keisuke Tateishi, Minoru Tada & Kazuhiko Koike

  2. Department of Gastroenterology, The Institute for Adult Diseases, Asahi Life Foundation, Chiyoda-ku, Tokyo, Japan

    Ayako Yanai & Masao Akanuma

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  1. Suguru Mizuno
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  2. Yousuke Nakai
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Correspondence to Yousuke Nakai.

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Mizuno, S., Nakai, Y., Isayama, H. et al. Risk factors and early signs of pancreatic cancer in diabetes: screening strategy based on diabetes onset age. J Gastroenterol 48, 238–246 (2013). https://doi.org/10.1007/s00535-012-0622-z

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  • DOI: https://doi.org/10.1007/s00535-012-0622-z

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