Weight loss at T2D onset is linked to increased pancreatic cancer risk

  • Yuan C & al.
  • JAMA Oncol
  • 13.08.2020

  • von Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Weight loss accompanying recent-onset diabetes is associated with increased pancreatic cancer risk.

Why this matters

  • Pancreatic cancer is often diagnosed too late for cure.
  • Clinicians may want to be alert to this risk association in the context of surveillance.

Study design

  • Cohort study data from 112,818 women and 46,207 men with 4.5 million person-years in US follow-up studies, sent biennial questionnaires.
  • Funding: Pussycat Foundation Helen Gurley Brown Presidential Initiative; NIH; Lustgarten Foundation; others. 

Key results

  • Pancreatic cancer occurred in 1116, for a rate of 25 per 100,000 person-years.
  • Age-adjusted (a)HR (95% CI) for those with (vs without) diabetes based on diabetes onset duration:
    • ≤4 years: 2.97 (2.31-3.82);
    • >4 years: 2.16 (1.78-2.60).
  • Compared with no weight loss, aHR (95% CI) for weight loss:
    • 1-4 pounds: 1.25 (1.03-1.52);
    • 5-8 pounds: 1.33 (1.06-1.66); and
    • >8 pounds: 1.92 (1.58-2.32).
  • Vs having no recent-onset diabetes and no 1-8 pounds weight loss, aHR (95% CI):
    • 3.61 (2.14-6.10) with both;
    • 6.75 (4.55-10.00) with weight loss >8 pounds. 
  • Incidence rate (95% CI) per 100,000:
    • 16 (14-17) with no recent-onset diabetes+no 1-8 pounds weight loss; 
    • 91 (55-151) with both; 
    • 164 (114-238) with weight loss >8 pounds.

Limitations

  • Missing questionnaire data.
  • Weight was assessed only every 2 years.
  • Study population was mostly white, all health care professionals.