Pancreatic Cancer

A new study suggests that the onset of diabetes after the age of 50 can be an early sign of pancreatic cancer. Pancreatic cancer is one of the deadliest types of cancers, as it has an overall five-year survival rate of about 8 percent.

Symptoms of pancreatic cancer can include abdominal pain, weight loss, and fatigue, according to the Mayo Clinic. Major risk factors include smoking, obesity, old age and family history. Smoking is estimated to cause approximately 30 percent of pancreatic cancer cases, according to the American Cancer Society.

A study published in the Journal of National Cancer Institute closely followed 50,000 African-American and Hispanic men and women above the age of 50 for about 20 years. There were no participants with diabetes at the beginning of the study.

Of the nearly 50,000 participants, researchers identified about 16,000 volunteers who had developed diabetes and about 400 who developed pancreatic cancer during the 20-year study period.

Those who developed diabetes were more than twice as likely to develop pancreatic cancer compared to those who did not develop diabetes, according to Wendy Setiawan, associate professor of preventative medicine at the Keck School of Medicine of the University of Southern California and a lead author of the study.

Out of a need to early identify patients with pancreatic cancer, Setiawan decided to take action. “We wanted to understand what are the characteristics of people in our study and other populations that help narrow down who are the high-risk populations,” Setiawan said.

Over 50 percent of the diabetic participants with pancreatic cancer were diagnosed with diabetes within three years of being diagnosed with cancer, according to Setiawan.

“If you really look at the Type 2 diabetes that pancreatic cancer patients have, the majority of those with diabetes are diagnosed very, very close to the time of the cancer diagnosis,” Setiawan said. “So people within recent-onset diabetes–which we defined as within 36 months from pancreatic cancer diagnosis– are at much higher risk for pancreatic cancer.”

This ultimately suggests that the development of diabetes, particularly later in life, can be a warning sign of pancreatic cancer for certain people and should be monitored more closely.

However, professor of medicine Dr. Robert Rushakoff at the University of California, San Francisco and medical director of the UCSF Diabetes Center at Mount Zion, mentioned the chances of pancreatic cancer are still slim, even for those who do develop diabetes after 50. Dr. Robert Rushakoff was not involved in the study.

“Patients develop Type 2 diabetes at a larger age. It is a common disease. Pancreatic cancer is relatively rare. There is no indication for general screening for pancreatic cancer in patients with diabetes,” Rushakoff wrote. Although these findings are informative, they do not change the diagnosis or treatment of diabetic patients.

According to the Mayo Clinic, diabetes occurs when the pancreas does not produce enough insulin or the body’s tissues become resistant to insulin, resulting in increased blood sugar levels.

Pancreatic cancer affects over 55,000 people in the United States every year and about 8 percent are diagnosed at a late stage, usually after cancer has spread to other parts of the body, according to a study conducted in 2015. When the cancer is found, it is unlikely that it will be removed successfully.

Unfortunately, there are no reliable screening tests for pancreatic cancer, and the identification of high-risk individuals could greatly increase the survival rate, according to Setiawan.

“Very little is known about what the risk factors are for this very fatal cancer,” Setiawan said. “So we tried to see if recent-onset diabetes could be used as an early marker for people who eventually develop pancreatic cancer.

Researchers choose to look to the African-American and Hispanic populations due to their higher risk of diabetes.

“It is interesting to see that the increased association of pancreatic cancer is seen in these groups,” Rushakoff said. “The prevalence of diabetes is high in these groups, so confirming the association of diabetes and pancreatic cancer in these groups would be important.”

Since the study only focused on two groups, the results cannot be applied to an entire population; however, they do suggest that those who develop diabetes might want to keep a close eye on their health to avoid the possibility of pancreatic cancer.