↑↑↑ Follow me, medicine, medicine, health, scientific research, and one of the world's most cutting-edge original articles every day. The association between
Type 2 diabetes and pancreatic cancer development has been recognized for more than a century, and diabetes may be a modifiable risk factor for pancreatic cancer. However, these studies included relatively small sample sizes of diabetes. In addition, few studies have investigated the relationship between the age of onset of diabetes and duration of diabetes and the incidence of pancreatic cancer in a large population.
People who are interested in related content can check out 
Pancreatic cancer is one of the main causes of cancer death in the world and in China. Pancreatic cancer usually has worse prognosis than most other tumors, with a 5-year survival rate below 5%. In 2020, The Lancet Oncology, The Lancet Gastroenterology , Hepatology and EBioMedicine published a cross-job series with four reviews, highlighting the progress made in various fields of pancreatic cancer research and emphasizing the need for joint efforts to reduce the burden of pancreatic cancer.
Previous studies have shown that early diagnosis and treatment can improve the overall prognosis of pancreatic cancer. However, screening of large populations in the general population is considered to be infeasible to detect disease at an early stage. The key to diagnosis and treatment is to identify people at high risk of pancreatic cancer as early as possible. Pancreatic cancer has identified many variable risk factors, including smoking, obesity and alcohol consumption, while age and familial cancer syndrome are considered an unchangeable risk factor for the disease.
Diabetes is a potentially modifiable risk factor for pancreatic cancer in the Asia-Pacific population. The global prevalence of type 2 diabetes is growing, and the growth of type 2 diabetes in Asia is expected to be higher than other continents, and faster. Due to rapid economic development and drastic changes in lifestyle, the prevalence of type 2 diabetes in China was reported to be 12·8%, showing a rapid increase in the past 30 years.
Impaired glucose metabolism is associated with poor macroscopic and microvascular outcomes, and the incidence of cancer is higher. The relationship between type 2 diabetes and the development of pancreatic cancer has indeed been recognized for more than a century. Convincing evidence suggests that type 2 diabetes is associated with an increased risk of pancreatic cancer, which can worsen cancer stages and increase cancer-related mortality.
However, few studies have investigated the relationship between the age of onset of diabetes and duration of diabetes and the incidence of pancreatic cancer in a large population. In addition, little is known about the effects of different levels of fasting blood glucose (FBG) on the risk of pancreatic cancer in patients with newly developed T2DM.
In this analysis, the researchers studied the relationship between the age of onset of diabetes and the duration of diabetes in pancreatic cancer, studied the relationship between different levels of FBG and pancreatic cancer risk, and used two-sample Mendel randomization (MR) to study other evidence supporting the causal relationship between type 2 diabetes and pancreatic cancer in a separate East Asian population. The association of
T2DM with pancreatic cancer and causal effects
Researchers conducted a longitudinal cohort study to evaluate the correlation between type 2 diabetes and pancreatic cancer risk. Data collected from the Shanghai Standardized Diabetes Management System (SSDMS) managed by the Shanghai Center for Disease Control and Prevention (SCDC) were analyzed.
Type 2 diabetes increases the incidence of pancreatic cancer
Researchers surveyed a total of 428,362 new patients with type 2 diabetes, including 205,694 for males and 222,668 for females. Compared with male type 2 diabetes, women are older and have lower fasting blood sugar (FBG). Compared with patients without pancreatic cancer, pancreatic cancer patients are older, with lower BMI and higher fasting blood sugar .
The BMI and fasting glucose in patients diagnosed with pancreatic cancer within 12 months after the diagnosis of type 2 diabetes were lower than the corresponding level of diagnosis more than 12 months after the diagnosis of diabetes. During the study period, a total of 1,056 cases of pancreatic cancer were found, starting from the diagnosis of type 2 diabetes, with an average follow-up of 4.5±2.2 years.
The incidence of pancreatic cancer in all patients with type 2 diabetes was 55.28/100000, respectively, and 59.61/100000 and 51.38/100000, respectively in men and women.Overall, the ASR of pancreatic cancer in patients with type 2 diabetes is 20.75/100.000. Compared with the general population, all patients with type 2 diabetes had a pancreatic cancer SIR of 1.54, males and females.
Absolute and relative risk of pancreatic cancer when onset in different age groups
0 The annual incidence of pancreatic cancer increased from 17.62/100000 in patients aged 20 to 54 years old to 40.76/100000 in patients aged 55 to 64 years old, the annual incidence of patients aged 65 to 74 years old was 68·45/100000, and 120.45/100000 in patients aged 75 years old.
The incidence of pancreatic cancer was observed significantly higher in the elderly group with type 2 diabetes. Relative pancreatic cancer risk is expressed as SIR, which is inversely proportional to the age at the onset of type 2 diabetes. Among those diagnosed with type 2 diabetes, the SIR was significantly higher than 5·73, while 1·91 was observed in patients aged 55-64, 1·46 was observed in patients aged 65-74, 1·24 was observed in patients aged 65-74, and 1·37 in the new T2DM group aged ≥75 years.
Risk of pancreatic cancer in patients with new type 2 diabetes in different age groups (A: all T2DM patients; B: male; C: female)
Association of duration of type 2 diabetes and risk of pancreatic cancer
Researchers studied the correlation between pancreatic cancer and duration of type 2 diabetes. During all 8-year follow-up, new type 2 diabetes was significantly associated with an increased risk of pancreatic cancer, ≤1 year (64.31; 1.73), within 6 years (58.55; 1.73), 7 years (59.47; 1.79) and over 7 years (57.42; 1.78). Similar phenomena were also found in the male and female analysed separately.
Pancreatic cancer risk in patients with type 2 diabetes with different durations (A: all patients with type 2 diabetes; B: male; C: female)
Causal relationship analysis of type 2 diabetes and pancreatic cancer
We believe that type 2 diabetes increases the risk of pancreatic cancer in East Asian population by 24%. However, elevated fasting blood sugar levels in the normal range have no causal relationship with pancreatic cancer risk.
MR analysis shows the causal effect of type 2 diabetes and fasting blood sugar on pancreatic cancer in East Asian population
Conclusion
This study mainly finds it can be summarized into three points:
(1) Newly-occurred type 2 diabetes patients have higher risk of pancreatic cancer among men and women in Chinese adults than in the general population, and the MR analysis shows that this is also in line with the causal relationship of East Asian population;
(2) This study investigated the absolute and relative risks of pancreatic cancer in different age groups. It was found for the first time that although the absolute risk of pancreatic cancer increases with age, the relative risks of pancreatic cancer are negatively correlated with age at the onset of type 2 diabetes. The SIR of people aged 20 to 54 years old increased significantly by 5.73;
(3) In a large-scale study on type 2 diabetes, the relationship between the risk of pancreatic cancer and the overall duration of diabetes was reported for the first time. Patients with diabetes diagnosed for more than 5 years and have high fasting blood sugar levels have an increased risk of pancreatic cancer, and those with excessive fasting blood sugar (FBG ≥10·0 mmol/L) have a 2.35-fold risk of pancreatic cancer than those of normal people (FBG 6·0 mmol/L).
To the best of our knowledge, this is the largest study in China on the incidence of pancreatic cancer in new-type 2 diabetes. New-type type 2 diabetes is significantly associated with the risk of pancreatic cancer in Chinese adults. Young patients with type 2 diabetes have a significantly higher relative risk of pancreatic cancer. Patients with type 2 diabetes have been diagnosed for more than 5 years and have an elevated fasting blood sugar level, and their risk of developing pancreatic cancer is increased. Therefore, efforts to conduct early and close follow-up programs and improve blood sugar control may be effective strategies to improve the incidence of pancreatic cancer.
Friends who are interested in related content can see why vegetarian food is beneficial to health?
html September 20th is National Teeth Love Day. Please eat less sugar to protect your teeth and prevent diabetes.
Welcome to recommend me to your family and friends
To ensure you can receive every article, please add attention!
If you like this article, please like and collect it~~
