Abstract
BACKGROUND: Type 2 diabetes mellitus has been associated with an excess risk of pancreatic cancer, but the magnitude of the risk and the time-risk relationship are unclear, and there is limited information on the role of antidiabetic medications.
PATIENTS AND METHODS: We analyzed individual-level data from 15 case-control studies within the Pancreatic Cancer Case-Control Consortium, including 8305 cases and 13 987 controls. Pooled odds ratios (ORs) were estimated from multiple logistic regression models, adjusted for relevant covariates.
RESULTS: Overall, 1155 (15%) cases and 1087 (8%) controls reported a diagnosis of diabetes 2 or more years before cancer diagnosis (or interview, for controls), corresponding to an OR of 1.90 (95% confidence interval, CI, 1.72-2.09). Consistent risk estimates were observed across strata of selected covariates, including body mass index and tobacco smoking. Pancreatic cancer risk decreased with duration of diabetes, but a significant excess risk was still evident 20 or more years after diabetes diagnosis (OR 1.30, 95% CI 1.03-1.63). Among diabetics, long duration of oral antidiabetic use was associated with a decreased pancreatic cancer risk (OR 0.31, 95% CI 0.14-0.69, for ≥15 years). Conversely, insulin use was associated with a pancreatic cancer risk in the short term (OR 5.60, 95% CI 3.75-8.35, for
CONCLUSION: This study provides the most definitive quantification to date of an excess risk of pancreatic cancer among diabetics. It also shows that a 30% excess risk persists for more than two decades after diabetes diagnosis, thus supporting a causal role of diabetes in pancreatic cancer. Oral antidiabetics may decrease the risk of pancreatic cancer, whereas insulin showed an inconsistent duration-risk relationship.
| Original language | English |
|---|---|
| Pages (from-to) | 2065-2072 |
| Number of pages | 8 |
| Journal | Annals of Oncology |
| Volume | 25 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Oct 1 2014 |
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Keywords
- case–control study
- diabetes
- insulin
- oral antidiabetics
- pancreatic cancer
- pooled analysis
ASJC Scopus subject areas
- Medicine(all)
Cite this
Diabetes, antidiabetic medications, and pancreatic cancer risk : an analysis from the International Pancreatic Cancer Case-Control Consortium. / Bosetti, C.; Rosato, V.; Li, D.; Silverman, D.; Petersen, G. M.; Bracci, P. M.; Neale, R. E.; Muscat, J.; Anderson, K.; Gallinger, S.; Olson, S. H.; Miller, A. B.; Bas Bueno-de-Mesquita, H.; Scelo, G.; Janout, V.; Holcatova, I.; Lagiou, P.; Serraino, D.; Lucenteforte, E.; Fabianova, E.; Ghadirian, P.; Baghurst, P. A.; Zatonski, W.; Foretova, L.; Fontham, E.; Bamlet, W. R.; Holly, E. A.; Negri, E.; Hassan, M.; Prizment, A.; Cotterchio, M.; Cleary, S.; Kurtz, R. C.; Maisonneuve, P.; Trichopoulos, D.; Polesel, J.; Duell, E. J.; Boffetta, P.; La Vecchia, C.
In: Annals of Oncology, Vol. 25, No. 10, 01.10.2014, p. 2065-2072.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Diabetes, antidiabetic medications, and pancreatic cancer risk
T2 - an analysis from the International Pancreatic Cancer Case-Control Consortium
AU - Bosetti, C.
AU - Rosato, V.
AU - Li, D.
AU - Silverman, D.
AU - Petersen, G. M.
AU - Bracci, P. M.
AU - Neale, R. E.
AU - Muscat, J.
AU - Anderson, K.
AU - Gallinger, S.
AU - Olson, S. H.
AU - Miller, A. B.
AU - Bas Bueno-de-Mesquita, H.
AU - Scelo, G.
AU - Janout, V.
AU - Holcatova, I.
AU - Lagiou, P.
AU - Serraino, D.
AU - Lucenteforte, E.
AU - Fabianova, E.
AU - Ghadirian, P.
AU - Baghurst, P. A.
AU - Zatonski, W.
AU - Foretova, L.
AU - Fontham, E.
AU - Bamlet, W. R.
AU - Holly, E. A.
AU - Negri, E.
AU - Hassan, M.
AU - Prizment, A.
AU - Cotterchio, M.
AU - Cleary, S.
AU - Kurtz, R. C.
AU - Maisonneuve, P.
AU - Trichopoulos, D.
AU - Polesel, J.
AU - Duell, E. J.
AU - Boffetta, P.
AU - La Vecchia, C.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - BACKGROUND: Type 2 diabetes mellitus has been associated with an excess risk of pancreatic cancer, but the magnitude of the risk and the time-risk relationship are unclear, and there is limited information on the role of antidiabetic medications.PATIENTS AND METHODS: We analyzed individual-level data from 15 case-control studies within the Pancreatic Cancer Case-Control Consortium, including 8305 cases and 13 987 controls. Pooled odds ratios (ORs) were estimated from multiple logistic regression models, adjusted for relevant covariates.RESULTS: Overall, 1155 (15%) cases and 1087 (8%) controls reported a diagnosis of diabetes 2 or more years before cancer diagnosis (or interview, for controls), corresponding to an OR of 1.90 (95% confidence interval, CI, 1.72-2.09). Consistent risk estimates were observed across strata of selected covariates, including body mass index and tobacco smoking. Pancreatic cancer risk decreased with duration of diabetes, but a significant excess risk was still evident 20 or more years after diabetes diagnosis (OR 1.30, 95% CI 1.03-1.63). Among diabetics, long duration of oral antidiabetic use was associated with a decreased pancreatic cancer risk (OR 0.31, 95% CI 0.14-0.69, for ≥15 years). Conversely, insulin use was associated with a pancreatic cancer risk in the short term (OR 5.60, 95% CI 3.75-8.35, for CONCLUSION: This study provides the most definitive quantification to date of an excess risk of pancreatic cancer among diabetics. It also shows that a 30% excess risk persists for more than two decades after diabetes diagnosis, thus supporting a causal role of diabetes in pancreatic cancer. Oral antidiabetics may decrease the risk of pancreatic cancer, whereas insulin showed an inconsistent duration-risk relationship.
AB - BACKGROUND: Type 2 diabetes mellitus has been associated with an excess risk of pancreatic cancer, but the magnitude of the risk and the time-risk relationship are unclear, and there is limited information on the role of antidiabetic medications.PATIENTS AND METHODS: We analyzed individual-level data from 15 case-control studies within the Pancreatic Cancer Case-Control Consortium, including 8305 cases and 13 987 controls. Pooled odds ratios (ORs) were estimated from multiple logistic regression models, adjusted for relevant covariates.RESULTS: Overall, 1155 (15%) cases and 1087 (8%) controls reported a diagnosis of diabetes 2 or more years before cancer diagnosis (or interview, for controls), corresponding to an OR of 1.90 (95% confidence interval, CI, 1.72-2.09). Consistent risk estimates were observed across strata of selected covariates, including body mass index and tobacco smoking. Pancreatic cancer risk decreased with duration of diabetes, but a significant excess risk was still evident 20 or more years after diabetes diagnosis (OR 1.30, 95% CI 1.03-1.63). Among diabetics, long duration of oral antidiabetic use was associated with a decreased pancreatic cancer risk (OR 0.31, 95% CI 0.14-0.69, for ≥15 years). Conversely, insulin use was associated with a pancreatic cancer risk in the short term (OR 5.60, 95% CI 3.75-8.35, for CONCLUSION: This study provides the most definitive quantification to date of an excess risk of pancreatic cancer among diabetics. It also shows that a 30% excess risk persists for more than two decades after diabetes diagnosis, thus supporting a causal role of diabetes in pancreatic cancer. Oral antidiabetics may decrease the risk of pancreatic cancer, whereas insulin showed an inconsistent duration-risk relationship.
KW - case–control study
KW - diabetes
KW - insulin
KW - oral antidiabetics
KW - pancreatic cancer
KW - pooled analysis
UR - http://www.scopus.com/inward/record.url?scp=84924610155&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84924610155&partnerID=8YFLogxK
U2 - 10.1093/annonc/mdu276
DO - 10.1093/annonc/mdu276
M3 - Article
VL - 25
SP - 2065
EP - 2072
JO - Annals of Oncology
JF - Annals of Oncology
SN - 0923-7534
IS - 10
ER -