Diabetics’ elevated risk for pancreatic cancer persisted long after diagnosis

The Pancreatic Cancer Case-Control Consortium, or PANC4, is a collaboration of a group of scientists of diverse biomedical disciplines from many different institutions across the world who conduct large case–control studies from pooled analyses of data to improve our understanding of pancreatic cancer. The size of the cohort of pooled data is a powerful tool for examining the epidemiology of pancreatic cancer, and the group has previously published important work examining the associations between tobacco use, alcohol consumption, pancreatitis and allergies with the risk for developing pancreatic cancer. The group continues and expands the scope of their work in this study looking at the influence of both diabetes and the use of antidiabetic medications on the risk for pancreatic cancer. There also is a nice discussion in the article that succinctly summarizes their work and places it into context. The PANC4 investigators demonstrate that a diagnosis of diabetes 2 or more years prior to cancer diagnosis (to censor out patients who develop diabetes just prior to diagnosis due to pancreatic insufficiency from the cancer) increases the risk for pancreatic cancer (OR=1.9), and that the chronic usage of oral antidiabetic agents is associated with a significantly reduced risk for development of pancreatic cancer (OR=0.31; 95% CI, 0.14-0.69). The latter finding is of particular significance given the interest in some oral antidiabetic agents as potential anticancer agents, through their effects in reducing insulin and insulin-like growth factor (IGF) levels — which can function to promote cell growth — or through a direct anti-proliferative effect. The results do indicate that further exploration of the potential anticancer effects of oral antidiabetic agents would be worthwhile.