Diabetes, antidiabetic medications, and pancreatic cancer risk: An analysis from the International Pancreatic Cancer Case-Control Consortium Journal Article

   

Authors:	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.; Bueno-de-Mesquita, H. B.; 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.
Article Title:	Diabetes, antidiabetic medications, and pancreatic cancer risk: An analysis from the International Pancreatic Cancer Case-Control Consortium
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:	prevalence; history; diagnosis; insulin; pancreatic; metformin; diabetes; body-mass index; metaanalysis; pooled analysis; case-control study; glucose-metabolism; mellitus; cancer; oral antidiabetics; temporal association
Journal Title:	Annals of Oncology
Volume:	25
Issue:	10
ISSN:	0923-7534
Publisher:	Oxford University Press
Date Published:	2014-10-01
Start Page:	2065
End Page:	2072
Language:	English
ACCESSION:	WOS:000343045500029
DOI:	10.1093/annonc/mdu276
PROVIDER:	wos
PMCID:	PMC4176453
PUBMED:	25057164
Notes:	Article -- Source: Wos

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