Diabetes After Age 50 Signals Risk of Pancreatic Cancer, New Study

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Adults with type 2 diabetes face a lot of serious health disorders, including about twice the increased risk of pancreatic cancer as those without the disease. Pancreatic cancer is relatively rare but typically has poor survival, partly because it’s often not diagnosed until the late stages.
Now a study suggests that the development of diabetes can be an early sign of pancreatic cancer for African-Americans and Latinos who are diagnosed with diabetes later in life. This study also confirms previous research, that having diabetes increases the risk of developing pancreatic cancer.
The study was published in The Journal of the National Cancer Institute.

Diabetes is more common in African-Americans and Latinos than white individuals living in the US. African Americans also have higher rates of pancreatic cancer incidence and mortality than any other racial or ethnic group.

AICR research shows that overweight and obesity increase the risk of pancreatic cancer. Having too much body fat is also a risk of many other cancers, including colorectal, esophageal and post-menopausal breast.

“This study adds a valuable piece of the puzzle to move ahead researchers’ understanding of how pancreatic cancer develops and health professionals’ identification of people who might benefit from extra attention to catch this cancer at an earlier stage than we often do,” said AICR Nutrition Advisor Karen Collins, MS, RDN, CDN, an expert on the diabetes and cancer prevention association.

Although it’s a small proportion of people diagnosed with type 2 diabetes who develop pancreatic cancer, some evidence suggests that factors related to diabetes – such as elevated insulin – may promote the development of this cancer, adds Collins.

“Take a diagnosis of diabetes or prediabetes as a call to action to take care of yourself with healthy eating and physical activity habits that will improve diabetes-related health and heart health and reduce overall cancer risk, not as a sign of unavoidable doom.”

Risk Factor and Consequence
Previous research has suggested that diabetes could be both a risk factor for and a consequence of pancreatic cancer. Here, the authors wanted to investigate how recent-onset diabetes – which they define as a diagnosis within 3 years –- links to pancreatic cancer among the two minority populations.
The study used data from approximately 49,000 African-Americans and Latinos who did not have diabetes when they signed up for the study back in the mid-1990s. Participants ranged from ages 45 to 75 at the start. Multiple questionnaires, Medicare data, and hospital files were used to identify those diagnosed with diabetes during the study.
By 2013, 408 of the study participants had developed pancreatic cancer.
Researchers then looked at the links between those who had developed pancreatic cancer and diabetes. Overall, having diabetes was linked to about twice the risk of developing pancreatic cancer compared to those without the disease.
The study found that people who were diagnosed with diabetes between the ages of 65 and 85 were more likely to develop pancreatic cancer within three years as compared to people without diabetes. At age 75, Latinos were four times more likely to develop pancreatic cancer within three years of a diabetes diagnosis, and African-Americans were three times more likely than those without diabetes.
No link was found between diabetes diagnosed after age 50 and breast, prostate or colorectal cancers among African Americans and Latinos.
Diabetes and cancers shared lifestyle risk factors
Along with pancreatic cancer, having diabetes increases the risk of several other cancers. Adults with diabetes have about twice the risk of developing cancers of the liver and endometrium and there’s a small but significant increase in risk for colon and post-menopausal breast cancers.

The two diseases – diabetes and cancer – share several key risk factors, including obesity and lack of physical activity.

AICR’s nutrition expert talks about the diabetes-cancer connection and the everyday lifestyle changes to lower risk of both. Linking Diabetes to Cancer: Changes for Prevention

A call to action
“Pancreatic cancer is a rare disease, but if you are diagnosed with late-onset diabetes, have a conversation with your clinician about your individual risk,” said the study’s lead author V. Wendy Setiawan, Ph.D., associate professor of preventive medicine at the Keck School of Medicine of USC. “Early intervention could improve survival.”

It’s also important to put this study in context, Collins notes; it should not add unnecessary worry and distraction for those diagnosed with type 2 diabetes. Pancreatic cancer is a relatively uncommon cancer and affects a small, small proportion of people who receive a diabetes diagnosis.
“Take a diagnosis of diabetes or prediabetes as a call to action to take care of yourself with healthy eating and physical activity habits that will improve diabetes-related health and heart health and reduce overall cancer risk, not as a sign of unavoidable doom.”

This study was supported by the National Institutes of Health and the American Cancer Society.

National Diabetes Statistics Report

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    Author: Mya Nelson

    Mya R. Nelson is at American Institute for Cancer Research, where she writes about the research in the field.

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