The Society of Surgical Oncology, inc.
The American Society of Breast Surgeons.
Annals of Surgical Oncology

Log in | Register

Association of Diabetes Mellitus and Pancreatic Adenocarcinoma: A Meta-Analysis of 88 Studies

Pikli Batabyal MBBS, Stephen Vander Hoorn MSc, BSc, Christopher Christophi MD, FACS, FRACS, Mehrdad Nikfarjam MD, PhD, FRACS
Pancreatic Tumors
Volume 21, Issue 7 / July , 2014

Abstract

Background

Pancreatic ductal adenocarcinoma (PDAC) is often diagnosed at an advanced, incurable stage. Previous epidemiological data suggests that diabetes mellitus (DM) is a risk factor for PDAC, which may be important in early detection. However, the strength of this association needs to be determined, taking into account a number of recently published studies.

Methods

A systematic review of the association between DM and PDAC was undertaken by searching electronic databases and journal references from 1973 to 2013. Summary estimates were obtained separately for case–control and cohort studies by means of a ‘random effects’ approach. Data pertaining to the DM was recorded and plotted at both an individual and study level, with the relative risks (RR) pooled separately to determine the relationship of DM duration and PDAC.

Results

A total of 88 independent studies, including 50 cohort and 39 case–control studies were examined. The overall summary-combined RR was 1.97 (95 % CI 1.78–2.18) with marked heterogeneity that could not be clearly attributed to any subgroup analyses. The risk of PDAC was greatest early after the diagnosis of DM but remained elevated long after the diagnosis. The individual-level RR ranged from 6.69 at less than 1 year to 1.36 at 10 years.

Conclusion

The results demonstrate a strong association between PDAC and recently diagnosed DM, which may be attributed to a paraneoplastic effect. However, the presence of diabetes also remains a modest risk factor for the development of PDAC long-term. Selective screening of patients with new-onset DM for PDAC needs to be considered.

Add a comment



0 comment(s)

ANNALS NOW ON TWITTER!

@AnnSurgOncol

Follow the journal on Twitter and help to expand the reach of the journal to help surgical oncologists and their patients.

 

MANUSCRIPT PROCESSING FEE

Effective January 2013, a manuscript processing fee of $50 USD is required for each initial new submission of an Annals article, excluding editorials. Submitted new manuscripts will not enter the review process until the submission fee has been paid. There is no processing fee associated with resubmitted manuscripts.

 

HIGHLIGHTED VIDEO OF THE MONTH

Lymphatic Mapping and Sentinel Node Biopsy in the Colonic Mesentery by Natural Orifice Transluminal Endoscopic Surgery (NOTES) by R. A. Cahill MD, FRCS, S. Perretta MD, J. Leroy MD, B. Dallemagne MD, and J. Marescaux MD, FRCS, FACS.  Annals of Surgical Oncology. Volume 15, Number 10, DOI: 10.1245/s10434-008-9952-8