Title

Impacts of New-Onset and Longstanding Diabetes on the Incidence and Mortality of Pancreatic Cancer: Population Based Big-Cohort Study.

Authors

Seon Mee Park; Joungho Han; Hyun Jung Kim; Hyeong Sik Ahn

Abstract

Background/Aims We evaluated the impacts of new-onset diabete (NODM) or longstanding diabete (LSDM) on the risk and prognosis of pancreatic cancer (PC). We also analyzed the influence of levels and changes of glucose and familial diabetic history. Methods Using Korean National Health Insurance data, NODM (n=550,949, 6.7%), LSDM (n=2,162,028, 26.2%), and non-DM (n=5,533,877, 67.1%) population (30 to 80 years old) were identified. Incidence and survival of PC in NODM or LSDM patients were compared to those of non-DM controls. Cox proportional hazard analysis was used to analyze the influence of levels and changes of glucose and family history of DM. We adjusted age, sex, alcohol drinking, smoking, cholesterol, and body mass index. Results The incidences of PC were highest in NODM for first 2 years and in LSDM after 2 years. PC incidences (105 person-year) at 1 year were 37.2 in NODM, 26.8 in LSDM, and 4.6 in non-DM persons. The hazard ratio (HR) for incidence was 3.72 in NODM and 2.0 in LSDM compared to non-DM persons. Risk of high glucose level (>160 mg/dL) was greater in NODM (HR, 3.46) than LSDM (HR 2.56). HR of glucose changes was higher in non-DM (HR, 2.18) than LSDM (HR, 1.39 to 1.68) or NODM (HR, 0.57 to 1.0). Absence of family history of DM increased risks in NODM (HR, 1.79), LSDM (HR, 1.33) and non-DM (HR, 1.33). Survival rates of PC in NODM or LSDM were better than non-DM persons in all age groups and both sexes. Conclusions NODM had two-fold high risks of PC than LSDM. NODM and LSDM revealed better prognosis than non-DM persons. High glucose levels or changes and absence of family history of DM were risk factors of PC incidence in diabetes.

Subjects

PANCREATIC cancer; CANCER-related mortality; NATIONAL health insurance; BODY mass index; DIABETES

Publication

Gut & Liver, 2019, Vol 13, Issue 6(suppl. 1), p78

ISSN

1976-2283

Publication type

Academic Journal