The DOI matches its Crossref record; 40 of the 40 references it cites were found in a registry or an index.
Diabetes, Weight Change, and Pancreatic Cancer Risk
Open accessAbstract
Importance: Pancreatic cancer is the third-leading cause of cancer death in the United States; however, few high-risk groups have been identified to facilitate early diagnosis strategies. Objective: To evaluate the association of diabetes duration and recent weight change with subsequent risk of pancreatic cancer in the general population. Design, Setting, and Participants: This cohort study obtained data from female participants in the Nurses' Health Study and male participants in the Health Professionals Follow-Up Study, with repeated exposure assessments over 30 years. Incident cases of pancreatic cancer were identified from self-report or during follow-up of participant deaths. Deaths were ascertained through reports from the next of kin, the US Postal Service, or the National Death Index. Data collection was conducted from October 1, 2018, to December 31, 2018. Data analysis was performed from January 1, 2019, to June 30, 2019. Exposures: Duration of physician-diagnosed diabetes and recent weight change. Main Outcome and Measures: Hazard ratios (HRs) for subsequent development of pancreatic cancer. Results: Of the 112 818 women (with a mean [SD] age of 59.4 [11.7] years) and 46 207 men (with a mean [SD] age of 64.7 [10.8] years) included in the analysis, 1116 incident cases of pancreatic cancers were identified. Compared with participants with no diabetes, those with recent-onset diabetes had an age-adjusted HR for pancreatic cancer of 2.97 (95% CI, 2.31-3.82) and those with long-standing diabetes had an age-adjusted HR of 2.16 (95% CI, 1.78-2.60). Compared with those with no weight loss, participants who reported a 1- to 4-lb weight loss had an age-adjusted HR for pancreatic cancer of 1.25 (95% CI, 1.03-1.52), those with a 5- to 8-lb weight loss had an age-adjusted HR of 1.33 (95% CI, 1.06-1.66), and those with more than an 8-lb weight loss had an age-adjusted HR of 1.92 (95% CI, 1.58-2.32). Participants with recent-onset diabetes accompanied by weight loss of 1 to 8 lb (91 incident cases per 100 000 person-years [95% CI, 55-151]; HR, 3.61 [95% CI, 2.14-6.10]) or more than 8 lb (164 incident cases per 100 000 person-years [95% CI, 114-238]; HR, 6.75 [95% CI, 4.55-10.00]) had a substantially increased risk for pancreatic cancer compared with those with neither exposure (16 incident cases per 100 000 person-years; 95% CI, 14-17). Incidence rates were even higher among participants with recent-onset diabetes and weight loss with a body mass index of less than 25 before weight loss (400 incident cases per 100 000 person-years) or whose weight loss was not intentional judging from increased physical activity or healthier dietary choices (334 incident cases per 100 000 person-years). Conclusions and Relevance: This study demonstrates that recent-onset diabetes accompanied by weight loss is associated with a substantially increased risk for developing pancreatic cancer. Older age, previous healthy weight, and no intentional weight loss further elevate this risk.
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“One such cohort is subjects with new-onset diabetes and a high score (≥3) on the Enriching New-Onset Diabetes for Pancreatic Cancer (END-PAC) model.4”
From Radiomics-based Machine-learning Models Can Detect Pancreatic Cancer on Prediagnostic Computed Tomography Scans at a Substantial Lead Time Before Clinical Diagnosis (2022) · cites this paper as [4]
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“Early detection offers survival benefit beyond lead time, as tumors are smaller in volume and more likely to be resectable when detected earlier.2-4”
From Radiomics-based Machine-learning Models Can Detect Pancreatic Cancer on Prediagnostic Computed Tomography Scans at a Substantial Lead Time Before Clinical Diagnosis (2022) · cites this paper as [4]
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Metadata
- Authors
- Yuan, C., Babic, A., Khalaf, N., Nowak, J. A., Brais, L. K., Rubinson, D. A., Ng, K., Aguirre, A. J., Pandharipande, P. V., Fuchs, C. S., Giovannucci, E. L., Stampfer, M. J., Rosenthal, M. H., Sander, C., Kraft, P., & Wolpin, B. M.
- Affiliations
- Harvard University (US)
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
- Michael E. DeBakey VA Medical Center (US)
- Brigham and Women's Hospital (US)
- Yale Cancer Center (US)
- Corresponding author
- Yuan, Chen
- ORCID
- Venue
- JAMA Oncology
- Publisher
- American Medical Association (AMA)
- Published
- 2020-10-08
- Volume
- 6
- Issue
- 10
- Pages
- e202948
- ISSN
- 2374-2437 (ISSN-L)
- PMC
- PMC7426876
- OpenAlex
- W3048739465
- Cited by
- 150
- References
- 40
- Citations by year
- 2026: 28 · 2025: 31 · 2024: 17 · 2023: 24 · 2022: 28 · 2021: 22
- FWCI
- 6.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Oncology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (K08CA218420, R01CA205406)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Keywords
- pancreatic cancer risk, diabetes duration, weight loss, recent-onset diabetes, long-standing diabetes, diabetes and cancer association, cancer risk factors, prospective cohort, Nurses' Health Study, Health Professionals Follow-up Study, early cancer detection, obesity and cancer risk, cancer screening guidelines, cancer survivorship, cancer survivorship support services, survivorship care
- MeSH terms
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Pancreatic Neoplasms, Cohort Studies, Weight Loss, Body Mass Index, Incidence, Diabetes Complications
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