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Gallstones, a cholecystectomy, chronic pancreatitis, and the risk of subsequent pancreatic cancer in diabetic patients: a population-based cohort study.
J Gastroenterol. 2013 Jun; 48(6):721-7.JG

Abstract

BACKGROUND

The causal association between diabetes and pancreatic cancer remains unclear in Asian populations. This study examined whether gallstones, a cholecystectomy, chronic pancreatitis and the treatment of antidiabetic agents affect the risk of subsequent pancreatic cancer for patients with diabetes in a Taiwanese population.

METHODS

Using claims data from the universal health insurance program in Taiwan, 449,685 newly diagnosed diabetic cases among insured people from 2000 to 2003 were identified as the case group. The comparison group, matched for gender, age, and the index year of the diabetes cohort, consisted of 325,729 persons without diabetes. Pancreatic cancer incidence was measured in both groups until the end of 2008. Other risk factors associated with this cancer were also measured.

RESULTS

The incidence of pancreatic cancer in the diabetic cohort was 2-fold greater than that in the comparison group (1.46 vs. 0.71 per 10,000 person-years) with an adjusted hazard ratio (HR) of 1.75 [95 % confidence interval (CI) 1.45-2.10]. The risk slightly increased for diabetic patients with gallstones, cholecystitis, and a cholecystectomy (HR 1.92, 95% CI 1.18-3.11), but greatly increased for those with comorbidity of chronic pancreatitis (HR 22.9, 95% CI 12.6-41.4). Pancreatic cancer risk also increased significantly for those patients who used more insulin for treating diabetes (OR 2.20, 95% CI 1.40-3.45).

CONCLUSION

Our data suggest that the risk of pancreatic cancer is moderately increased in patients with diabetes, especially those using insulin therapy. The risk is greatly increased for diabetic patients with chronic pancreatitis.

Authors+Show Affiliations

School of Chinese Medicine, China Medical University, Taichung, 404, Taiwan. t674233@ms54.hinet.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23053420

Citation

Lai, Hsueh-Chou, et al. "Gallstones, a Cholecystectomy, Chronic Pancreatitis, and the Risk of Subsequent Pancreatic Cancer in Diabetic Patients: a Population-based Cohort Study." Journal of Gastroenterology, vol. 48, no. 6, 2013, pp. 721-7.
Lai HC, Tsai IJ, Chen PC, et al. Gallstones, a cholecystectomy, chronic pancreatitis, and the risk of subsequent pancreatic cancer in diabetic patients: a population-based cohort study. J Gastroenterol. 2013;48(6):721-7.
Lai, H. C., Tsai, I. J., Chen, P. C., Muo, C. H., Chou, J. W., Peng, C. Y., Lai, S. W., Sung, F. C., Lyu, S. Y., & Morisky, D. E. (2013). Gallstones, a cholecystectomy, chronic pancreatitis, and the risk of subsequent pancreatic cancer in diabetic patients: a population-based cohort study. Journal of Gastroenterology, 48(6), 721-7. https://doi.org/10.1007/s00535-012-0674-0
Lai HC, et al. Gallstones, a Cholecystectomy, Chronic Pancreatitis, and the Risk of Subsequent Pancreatic Cancer in Diabetic Patients: a Population-based Cohort Study. J Gastroenterol. 2013;48(6):721-7. PubMed PMID: 23053420.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gallstones, a cholecystectomy, chronic pancreatitis, and the risk of subsequent pancreatic cancer in diabetic patients: a population-based cohort study. AU - Lai,Hsueh-Chou, AU - Tsai,I-Ju, AU - Chen,Pei-Chun, AU - Muo,Chih-Hsin, AU - Chou,Jen-Wei, AU - Peng,Cheng-Yuan, AU - Lai,Shih-Wei, AU - Sung,Fung-Chang, AU - Lyu,Shu-Yu, AU - Morisky,Donald E, Y1 - 2012/10/03/ PY - 2012/01/19/received PY - 2012/08/21/accepted PY - 2012/10/12/entrez PY - 2012/10/12/pubmed PY - 2013/12/16/medline SP - 721 EP - 7 JF - Journal of gastroenterology JO - J Gastroenterol VL - 48 IS - 6 N2 - BACKGROUND: The causal association between diabetes and pancreatic cancer remains unclear in Asian populations. This study examined whether gallstones, a cholecystectomy, chronic pancreatitis and the treatment of antidiabetic agents affect the risk of subsequent pancreatic cancer for patients with diabetes in a Taiwanese population. METHODS: Using claims data from the universal health insurance program in Taiwan, 449,685 newly diagnosed diabetic cases among insured people from 2000 to 2003 were identified as the case group. The comparison group, matched for gender, age, and the index year of the diabetes cohort, consisted of 325,729 persons without diabetes. Pancreatic cancer incidence was measured in both groups until the end of 2008. Other risk factors associated with this cancer were also measured. RESULTS: The incidence of pancreatic cancer in the diabetic cohort was 2-fold greater than that in the comparison group (1.46 vs. 0.71 per 10,000 person-years) with an adjusted hazard ratio (HR) of 1.75 [95 % confidence interval (CI) 1.45-2.10]. The risk slightly increased for diabetic patients with gallstones, cholecystitis, and a cholecystectomy (HR 1.92, 95% CI 1.18-3.11), but greatly increased for those with comorbidity of chronic pancreatitis (HR 22.9, 95% CI 12.6-41.4). Pancreatic cancer risk also increased significantly for those patients who used more insulin for treating diabetes (OR 2.20, 95% CI 1.40-3.45). CONCLUSION: Our data suggest that the risk of pancreatic cancer is moderately increased in patients with diabetes, especially those using insulin therapy. The risk is greatly increased for diabetic patients with chronic pancreatitis. SN - 1435-5922 UR - https://www.unboundmedicine.com/medline/citation/23053420/Gallstones_a_cholecystectomy_chronic_pancreatitis_and_the_risk_of_subsequent_pancreatic_cancer_in_diabetic_patients:_a_population_based_cohort_study_ L2 - https://dx.doi.org/10.1007/s00535-012-0674-0 DB - PRIME DP - Unbound Medicine ER -