Association between age at diabetes onset or diabetes duration and subsequent risk of pancreatic cancer: Results from a longitudinal cohort and mendelian randomization study

Baiyong Shen, Yanyun Li, Chang Sheng Sheng, Lili Liu, Tianzhichao Hou, Nan Xia, Siming Sun, Ya Miao, Yi Pang, Kai Gu, Xiongxiong Lu, Chenlei Wen, Yi Cheng, Yulin Yang, Dan Wang, Yijie Zhu, Minna Cheng, Katie Harris, Zachary T. Bloomgarden, Jingyan TianJohn Chalmers, Yan Shi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The aim of the study is to estimate the incidence of pancreatic cancer among individuals with new-onset type 2 Diabetes (T2DM) and evaluate the relationship of pancreatic cancer risk with age at diabetes onset and diabetes duration. Methods: This longitudinal cohort study included 428,362 new-onset T2DM patients in Shanghai and Mendelian randomization (MR) in the east-Asian population were used to investigate the association. Incidence rates of pancreatic cancer in all patients and by subgroups were calculated and compared to the general population. Findings: A total of 1056 incident pancreatic cancer cases were identified during eight consecutive years of follow-up. The overall pancreatic cancer annual incidence rate was 55·28/100,000 person years in T2DM patients, higher than that in the general population, with a standardized incidence ratio (SIR) of 1·54 (95% confidence interval [CI], 1·45–1·64). The incidence of pancreatic cancer increased with age and a significantly higher incidence was observed in the older groups with T2DM. However, the relative pancreatic cancer risk was inversely related to age of T2DM onset, and a higher SIR of 5·73 (95%CI, 4·49–7·22) was observed in the 20–54 years old group. The risk of pancreatic cancer was elevated at any diabetes duration. Fasting blood glucose ≥10·0 mmol/L was associated with increased risk of pancreatic cancer. MR analysis indicated a positive association between T2DM and pancreatic cancer risk. Interpretation: Efforts toward early and close follow-up programs, especially in individuals with young-onset T2DM, and the improvement of glucose control might represent effective strategies for improving the detection and results of treatment of pancreatic cancer. Funding: Chinese National Natural Science Foundation.

Original languageEnglish
Article number100596
JournalThe Lancet Regional Health - Western Pacific
Volume30
DOIs
StateAccepted/In press - 2022

Keywords

  • Diabetes duration
  • Mendelian randomization
  • Onset age
  • Pancreatic cancer
  • Type 2 diabetes mellitus

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