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Late-Onset Diabetes: An Early Sign of Pancreatic Cancer for African Americans and Latinos

Jul 21, 2018
 

Late onset diabetes could be a warning sign for pancreatic cancer for African Americans and Latinos in particular, according to new study; African Americans with type 2 diabetes mellitus (T2DM) have a higher risk of developing pancreatic cancer relative to other ethnic groups.

Pancreatic cancer (PC) accounts for 7% of all types of cancers in both men and women and is the fourth leading cause of cancer deaths in the U.S. With a five-year survival rate of 8 % and up to 80% of the cases diagnosed at a late stage, the relationship between diabetes and PC might help to get a better prognosis and improve the quality of life of these patients. Since diabetes has been proposed as a risk factor and the outcomes of PC in minorities are limited, members of Keck School of Medicine of USC published a Cohort Study that shows the relationship between African Americans with T2DM and Latinos with T2DM and the risk of developing PC. They evaluated the association between recent-onset diabetes and incidence of pancreatic cancer in a prospective study of both populations, as they have high diabetes risk but differ in rates of pancreatic cancer.

For this study they used questionnaires, files from centers of Medicare and Medicaid, and hospital discharge information in order to identify the 49,000 patients with new diabetes diagnoses. Participants younger than 50 years old or those who have been diagnosed with diabetes or cancer other than non-melanoma skin cancer were excluded before cohort entry. Moreover, the information regarding cancer occurrence was collected using the annual data from the California State Cancer Registry. The diabetes cases were divided in two different groups, recent-onset for patients who have diabetes for three or fewer years and late-onset for those patients who have had diabetes for more than three years preceding the cancer diagnosis.

The data showed that people who were diagnosed with diabetes between the ages of 65 and 85 were more likely to develop pancreatic cancer within three years as compared with those who don’t have diabetes. Furthermore, the association between recent-onset diabetes and pancreatic cancer substantially declines with aging. The results also have shown that African Americans were three times more likely to develop PC within three years of a diabetes diagnosis and Latinos were four times more likely.  The authors also evaluated the association between late-onset diabetes and other types of cancer such as breast, prostate, and colorectal, and no relationship was found.

The authors have stated that this study supports the hypothesis that recent-onset diabetes in PC is a manifestation of developing the disease and recognize that more studies have to be done in order to understand the mechanism of the PC-Diabetes relationship.

Practice Pearls:

  • The American Cancer Society estimates more than 53,000 people will be diagnosed with pancreatic cancer in 2017.
  • The study suggests that late-onset diabetes may be an early sign and a possible useful marker of pancreatic cancer, leading to an early intervention, which can result in the better prognosis of the disease.
  • In order to better understand the mechanism by which diabetes and pancreatic cancer are related, new research should be done with the purpose of developing preventive and therapeutic strategies for pancreatic cancer and diabetes..

Reference:

Setiawan, Veronica Wendy, et al. “Pancreatic Cancer Following Incident Diabetes in African Americans and Latinos: The Multiethnic Cohort.” JNCI: Journal of the National Cancer Institute, 2018, doi:10.1093/jnci/djy090.

Kennen Munoz Munoz, Pharm. D. Candidate 2019, LECOM School of Pharmacy