Abstract
Purpose: To evaluate diabetes mellitus as a risk factor for pancreatic cancer in the veteran population Background: Pancreatic cancer is the fourth most common cause of cancer death in the USA., claiming 300,000 lives per year. Known risk factors include smoking, family history and a high caloric intake. Both diabetes mellitus and the pre-diabetic state have been associated with an increased risk of pancreatic cancer. Methods: A retrospective cross sectional case control study was conducted using data from the VISN 16 VA database from 1998 to 2004. We analyzed 501,350 patients from 4 states (LA, MS, TX, AK) In the selected group, the mean age was 61.4(S.D +/-14.4) years and 92.1% were males. Patients with pancreatic cancer were identified with ICD-9 diagnostic code of 157.x. Multiple logistic regression analysis was done and the data was adjusted for age, alcohol use, smoking, BMI and gallstone disease. A confidence interval (CI) of 95% was used universally in the data analysis. Statistical analysis was performed using SAS software version 9.0 (Chicago, IL). Results: Of the 501350 patients analyzed, 106825 (21%) patients had diabetes, of which 199 (0.19%) had pancreatic cancer. In the control group with 394525 (78%) patients, 279 (0.07%) had pancreatic cancer. Patients with diabetes had a higher incidence of pancreatic cancer when compared to the non-diabetic group (Odds Ratio (OR) 2.59, CI 2.12 to 3.18). The data was controlled for age, alcohol use, smoking, BMI and gallstone disease. The other significant covariates include smoking (OR 1.40, CI 1.01 to 1.96), gallstone disease (OR 4.56, CI 3.10 to 6.70). Discussion: The data should be viewed with caution as the duration and extent of diabetes was not factored in the analysis. Furthermore the study was a case controlled study limited to the veteran population and the risks from family history and pancreatitis were not incorporated. The large size of the study however negated some of these limitations. Conclusions: Utilizing the VA database comprising of half a million patients we established an association between diabetes and pancreatic cancer. These results negate previous studies that failed to establish such a link.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
