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New-onset Diabetes Patients Need Pancreatic Cancer Screening?

Lee, Jin Hee MD*; Kim, Su-A MD*; Park, Ho Yong MD*; Lee, Kwang Hyuck MD*; Lee, Kyu Taek MD*; Lee, Jong Kyun MD, PhD*; Bae, Ji Cheol MD; Kim, Kwang Won MD

Journal of Clinical Gastroenterology: August 2012 - Volume 46 - Issue 7 - p e58–e61
doi: 10.1097/MCG.0b013e318238348c
ONLINE ARTICLES: Original Articles
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Objective: Because patients with new-onset diabetes mellitus (DM) have a significantly increased likelihood of association with pancreatic cancer, we need to select the subgroup of diabetic patients who have more chance of association with pancreatic cancer.

Methods: We retrospectively reviewed medical records of case group (151 patients with pancreatic cancer with new-onset DM) and control group (302 patients with new-onset DM without cancer).

Results: Compared with the control group, pancreatic cancer group were older, had more weight loss, lower usual body mass index (BMI), more family history of pancreatic cancer (3.3% vs. 0.7%; P=0.044), and had less family history of DM (13.9% vs. 37.4%; P<0.001). If a new-onset DM patient did not have family history of DM, he was of age older than or equal to 65 years or had weight loss of >2 kg or had premorbid usual BMI <25 kg/m2, pancreatic cancer associated DM could be discriminated from new-onset type 2 DM with 80.8% sensitivity, 67.6% specificity, 2.5% and 99.7% of positive and negative predictability for pancreatic cancer, respectively.

Conclusions: Among patients who meet criteria for diabetes within 2 years, those who are elderly, have lower premorbid BMI, weight loss, no family history of DM, need screening of pancreatic cancer.

*Department of Medicine, Division of Gastroenterology

Division of Endocrinology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

The authors declare that they have nothing to disclose.

Reprints: Jong Kyun Lee, MD, PhD, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea (e-mail: jongk.lee@samsung.com).

Received June 29, 2011

Accepted September 16, 2011

© 2012 Lippincott Williams & Wilkins, Inc.