Abstract Title:

Diabetes, antidiabetic medications and pancreatic cancer risk: an analysis from the international pancreatic cancer case-control consortium.

Abstract Source:

Ann Oncol. 2014 Jul 23. Epub 2014 Jul 23. PMID: 25057164

Abstract Author(s):

C Bosetti, V Rosato, D Li, D Silverman, G M Petersen, P M Bracci, R E Neale, J Muscat, K Anderson, S Gallinger, S H Olson, A B Miller, H Bas Bueno-de-Mesquita, G Scelo, V Janout, I Holcatova, P Lagiou, D Serraino, E Lucenteforte, E Fabianova, P Ghadirian, P A Baghurst, W Zatonski, L Foretova, E Fontham, W R Bamlet, E A Holly, E Negri, M Hassan, A Prizment, M Cotterchio, S Cleary, R C Kurtz, P Maisonneuve, D Trichopoulos, J Polesel, E J Duell, P Boffetta, C La Vecchia

Article Affiliation:

C Bosetti


BACKGROUND: Type 2 diabetes mellitus has been associated with an excess risk of pancreatic cancer, but the magnitude of the risk and the time-risk relationship are unclear, and there is limited information on the role of antidiabetic medications.

PATIENTS AND METHODS: We analyzed individual-level data from 15 case-control studies within the Pancreatic Cancer Case-Control Consortium, including 8305 cases and 13,987 controls. Pooled odds ratios (ORs) were estimated from multiple logistic regression models, adjusted for relevant covariates RESULTS: Overall, 1155 (15%) cases and 1087 (8%) controls reported a diagnosis of diabetes two or more years before cancer diagnosis (or interview, for controls), corresponding to an odds ratio (OR) of 1.90 (95% confidence interval, CI, 1.72-2.09). Consistent risk estimates were observed across strata of selected covariates, including body mass index and tobacco smoking. Pancreatic cancer risk decreased with duration of diabetes, but a significant excess risk was still evident 20 or more years after diabetes diagnosis (OR 1.30 95% CI 1.17-2.03). Among diabetics, long duration of oral antidiabetic use was associated with a decreased pancreatic cancer risk (OR 0.31, 95% CI 0.14-0.69, for≥15 years). Conversely, insulin use was associated with pancreatic cancer risk in the short-term (OR 5.60, 95% CI 3.75-8.35 for<5 years) but not for longer duration of use (OR 0.95, 95% CI 0.53-1.70, for≥15 years).

CONCLUSION: This study provides the most definitive quantification to date of an excess risk of pancreatic cancer among diabetics. It also shows a 30% excess risk persists for more than two decades after diabetes diagnosis, thus supporting a causal role of diabetes in pancreatic cancer. Oral antidiabetics may decrease risk of pancreatic cancer risk, whereas insulin showed an inconsistent duration-risk relationship.

Study Type : Human Study
Additional Links
Problem Substances : Insulin : CK(384) : AC(68)
Adverse Pharmacological Actions : Carcinogenic (suspected) : CK(491) : AC(72)

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