Diabetes and risk of pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium.
Elena JW., Steplowski E., Yu K., Hartge P., Tobias GS., Brotzman MJ., Chanock SJ., Stolzenberg-Solomon RZ., Arslan AA., Bueno-de-Mesquita HB., Helzlsouer K., Jacobs EJ., LaCroix A., Petersen G., Zheng W., Albanes D., Allen NE., Amundadottir L., Bao Y., Boeing H., Boutron-Ruault MC., Buring JE., Gaziano JM., Giovannucci EL., Duell EJ., Hallmans G., Howard BV., Hunter DJ., Hutchinson A., Jacobs KB., Kooperberg C., Kraft P., Mendelsohn JB., Michaud DS., Palli D., Phillips LS., Overvad K., Patel AV., Sansbury L., Shu XO., Simon MS., Slimani N., Trichopoulos D., Visvanathan K., Virtamo J., Wolpin BM., Zeleniuch-Jacquotte A., Fuchs CS., Hoover RN., Gross M.
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.