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Diabetes mellitus, other medical conditions and pancreatic cancer: a case‐control study
Author(s) -
Lipworth Loren,
Zucchetto Antonella,
Bosetti Cristina,
Franceschi Silvia,
Talamini Renato,
Serraino Diego,
McLaughlin Joseph K.,
La Vecchia Carlo,
Negri Eva
Publication year - 2011
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.1162
Subject(s) - medicine , diabetes mellitus , pancreatic cancer , odds ratio , pancreatitis , case control study , confidence interval , logistic regression , cancer , gastroenterology , endocrinology
Abstract Background Diabetes and other medical conditions have been related to pancreatic cancer, but time risk quantification is unsettled. Methods We combined data from two case‐control studies conducted in Italy, including 688 pancreatic cancer cases and 2204 controls. All subjects were interviewed by trained interviewers during their hospital stay. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using multiple logistic regression. Results Overall, 103 cases (15%) and 125 controls (5.7%) reported a history of diabetes. The OR for pancreatic cancer was more pronounced among those diagnosed with diabetes in the previous 2 years (OR = 5.17; 95% CI = 2.71–9.87) than among those with diabetes diagnosed more than 2 years ago (OR = 2.35; 95% CI = 1.70–3.26). The ORs remained significantly elevated 2–4 years (OR = 3.81; 95% CI = 2.07–7.04) and 5–9 years (OR = 3.75; 95% CI = 2.13–6.59) since diagnosis of diabetes, after which a non‐significant 20% increased risk for pancreatic cancer was observed. As compared to non‐diabetic non‐smokers, the OR was 1.85 among non‐diabetic current smokers, 2.17 among diabetic never/former smokers, and rose to 4.67 among diabetic current smokers, indicating a multiplicative effect between these two risk factors. Pancreatic cancer was significantly associated with pancreatitis, primarily among those diagnosed within 2 years (OR = 7.16; 95% CI = 2.25–22.78). In addition, the ORs were elevated for cholelithiasis (3.53; 95% CI = 1.67–7.45) and gastroduodenal ulcer (3.16; 95% CI = 1.14–8.73) only among those diagnosed within the past 2 years. Conclusions Diabetes is associated with heightened risk of pancreatic cancer. The association is significant for diabetes diagnosed up to 10 years before pancreatic cancer. Copyright © 2011 John Wiley & Sons, Ltd.