Abstract
The incidence of pancreatic cancer (PCa) is increasing worldwide and has become one of the leading causes of cancer-related death. Screening for high risk populations is fundamental to overcome this intractable malignancy. Diabetes mellitus (DM) is classically known as a risk factor for PCa. Recently the reverse causality is in the spotlight, that is to say, DM is considered to be a manifestation of PCa. Numbers of epidemiological studies clarified that new-onset DM (≤2-year duration) was predominant in PCa patients and the relative risk for PCa inversely correlated with duration of DM. Among patients with new-onset DM, elder onset, weight loss, and rapid exacerbation of glycemic control were reported to be promising risk factors and signs, and the model was developed by combining these factors. Several pilot studies disclosed the possible utility of biomarkers to discriminate PCa-associated DM from type 2 DM. However, there is no reliable biomarkers to be used in the practice. We previously reported the application of a multivariate index for PCa based on the profile of plasma free amino acids (PFAAs) among diabetic patients. We are further investigating on the PFAA profile of PCa-associated DM, and it can be useful for developing the novel biomarker in the near future.
Highlights
The incidence of pancreatic cancer (PCa) is increasing worldwide, and PCa has become the 3rd leading cause of cancer-related death in the US [1] and the 4th in Japan [2]
We previously reported that PCa patients without symptoms, such as jaundice, pain, and appetite appetite loss, in whom new-onset Diabetes mellitus (DM) was a only clue to diagnosis of PCa had better prognosis than loss, in whom new-onset DM was a only clue to diagnosis of PCa had better prognosis than symptomatic symptomatic patients [19]
In addition to the risk stratification by using the combination of risk factors, development of biomarkers to discriminate PCa-associated DM, which is classified as type 3c DM, from type 2 DM is expected to be useful for the effective PCa screening
Summary
The incidence of pancreatic cancer (PCa) is increasing worldwide, and PCa has become the 3rd leading cause of cancer-related death in the US [1] and the 4th in Japan [2]. We discuss the risk factors and biomarkers for PCa in diabetic patients is warranted. We discuss the risk factors and biomarkers for PCa in diabetic patients. The RR for PCa gradually decreased according to diabetes patients with short duration of year or less. New-onset DM can be a diagnostic clue to select high risk populations among diabetic patients. Screening for PCa among patients with new-onset DM can improve the prognosis. Damiano J et al reported that routine imaging, new-onset and after resonance age 55 years [39]. To effective screening in patients with new-onset DM, further selection using risk factors and biomarkers is warranted. 3. Risk Factors for Pancreatic Cancer in Patients with New-Onset Diabetes Mellitus
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