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Diabetes mellitus and pancreatic cancer in a population-based case-control study in the San Francisco Bay Area, California.
Cancer Epidemiol Biomarkers Prev 2006; 15(8):1458-63CE

Abstract

BACKGROUND

Diabetes has been postulated to be both a risk factor and a consequence of pancreatic cancer, but the degree of risk and associated clinical factors remain unclear.

METHODS

We conducted a population-based case-control study of pancreatic cancer in the San Francisco Bay Area between 1995 and 1999. Rapid case ascertainment through the Surveillance, Epidemiology and End Results registry for cases and random selection from the general population for controls were employed to identify study participants with no proxy interviews.

RESULTS

Five hundred thirty-two cases and 1,701 controls were interviewed. Participants with pancreatic cancer were more likely to report a history of diabetes (13%) than were controls [9%; odds ratio (OR), 1.5; 95% confidence interval (95% CI), 1.1-2.1]. Compared with diabetics in the control group, diabetics in the case group had a shorter duration of diabetes (P = 0.0003) and a larger proportion of insulin users (P = 0.002). Risk for pancreatic cancer varied with duration of diabetes (OR, 2.4; 95% CI, 1.4-4.0 for 1-4 years; OR, 2.0; 95% CI, 1.2-3.4 for 5-9 years; and OR, 0.86; 95% CI, 0.52-1.4 for >or=10 years diabetes duration; P(trend) = 0.004). Among diabetics, use of oral diabetes medication or insulin for >or=5 years was not associated with pancreatic cancer, but insulin use of <5 years was associated with a 6.8-fold risk for pancreatic cancer (95% CI, 3.7-12).

CONCLUSION

Recent-onset diabetes may be a complication or an early marker of pancreatic cancer. Diabetes of short duration with insulin use conferred a substantially elevated risk for pancreatic cancer and may reflect insulin resistance that is elicited by pancreatic cancer.

Authors+Show Affiliations

Department of Epidemiology and Biostatistics, University of California San Francisco, Suite 280, 3333 California Street, San Francisco, CA 94118-1944, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16896032

Citation

Wang, Furong, et al. "Diabetes Mellitus and Pancreatic Cancer in a Population-based Case-control Study in the San Francisco Bay Area, California." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 15, no. 8, 2006, pp. 1458-63.
Wang F, Gupta S, Holly EA. Diabetes mellitus and pancreatic cancer in a population-based case-control study in the San Francisco Bay Area, California. Cancer Epidemiol Biomarkers Prev. 2006;15(8):1458-63.
Wang, F., Gupta, S., & Holly, E. A. (2006). Diabetes mellitus and pancreatic cancer in a population-based case-control study in the San Francisco Bay Area, California. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 15(8), pp. 1458-63.
Wang F, Gupta S, Holly EA. Diabetes Mellitus and Pancreatic Cancer in a Population-based Case-control Study in the San Francisco Bay Area, California. Cancer Epidemiol Biomarkers Prev. 2006;15(8):1458-63. PubMed PMID: 16896032.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diabetes mellitus and pancreatic cancer in a population-based case-control study in the San Francisco Bay Area, California. AU - Wang,Furong, AU - Gupta,Samir, AU - Holly,Elizabeth A, PY - 2006/8/10/pubmed PY - 2006/12/13/medline PY - 2006/8/10/entrez SP - 1458 EP - 63 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 15 IS - 8 N2 - BACKGROUND: Diabetes has been postulated to be both a risk factor and a consequence of pancreatic cancer, but the degree of risk and associated clinical factors remain unclear. METHODS: We conducted a population-based case-control study of pancreatic cancer in the San Francisco Bay Area between 1995 and 1999. Rapid case ascertainment through the Surveillance, Epidemiology and End Results registry for cases and random selection from the general population for controls were employed to identify study participants with no proxy interviews. RESULTS: Five hundred thirty-two cases and 1,701 controls were interviewed. Participants with pancreatic cancer were more likely to report a history of diabetes (13%) than were controls [9%; odds ratio (OR), 1.5; 95% confidence interval (95% CI), 1.1-2.1]. Compared with diabetics in the control group, diabetics in the case group had a shorter duration of diabetes (P = 0.0003) and a larger proportion of insulin users (P = 0.002). Risk for pancreatic cancer varied with duration of diabetes (OR, 2.4; 95% CI, 1.4-4.0 for 1-4 years; OR, 2.0; 95% CI, 1.2-3.4 for 5-9 years; and OR, 0.86; 95% CI, 0.52-1.4 for >or=10 years diabetes duration; P(trend) = 0.004). Among diabetics, use of oral diabetes medication or insulin for >or=5 years was not associated with pancreatic cancer, but insulin use of <5 years was associated with a 6.8-fold risk for pancreatic cancer (95% CI, 3.7-12). CONCLUSION: Recent-onset diabetes may be a complication or an early marker of pancreatic cancer. Diabetes of short duration with insulin use conferred a substantially elevated risk for pancreatic cancer and may reflect insulin resistance that is elicited by pancreatic cancer. SN - 1055-9965 UR - https://www.unboundmedicine.com/medline/citation/16896032/Diabetes_mellitus_and_pancreatic_cancer_in_a_population_based_case_control_study_in_the_San_Francisco_Bay_Area_California_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&amp;pmid=16896032 DB - PRIME DP - Unbound Medicine ER -