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Type: Journal article
Title: Diabetes, antidiabetic medications, and pancreatic cancer risk: an analysis from the International Pancreatic Cancer Case-Control Consortium
Author: Bosetti, C.
Rosato, V.
Li, D.
Silverman, D.
Petersen, G.
Bracci, P.
Neale, R.
Muscat, J.
Anderson, K.
Gallinger, S.
Olson, S.
Miller, A.
Bueno-de-Mesquita, H.
Scelo, G.
Janout, V.
Holcatova, I.
Lagiou, P.
Serraino, D.
Lucenteforte, E.
Fabianova, E.
et al.
Citation: Annals of Oncology, 2014; 25(10):2065-2072
Publisher: Oxford University Press (OUP)
Issue Date: 2014
ISSN: 1569-8041
Statement of
C. Bosetti ... P. A. Baghurst ... et al.
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 <5 years), but not for longer duration of use (OR 0.95, 95% CI 0.53-1.70, for ≥15 years). 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.
Keywords: case–control study; diabetes; insulin; oral antidiabetics; pancreatic cancer; pooled analysis
Rights: © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email:
RMID: 0030022903
DOI: 10.1093/annonc/mdu276
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Appears in Collections:Paediatrics publications

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