Risk of Pancreatic Cancer in Glycemically Defined New-Onset Diabetes: A Prospective Cohort Study

Authors

Suresh T Chari
Bechien Wu
Camden Lopez
Eva Lustigova
Qiaoling Chen
Stephen K Van Den Eeden
Amethyst D Leimpeter
William Fisher
Amy Wood
Ashley S Alexander
John Valenta
Santhi Swaroop Vege
Erin E Carlson
Kari G Rabe
Phil A Hart
Lu Qian
Ying-Qi Zhao
Nadia Yosuf
Lynn Matrisian
Barbara Kenner
Jo Ann Rinaudo
Anirban Maitra
Ziding Feng

Publication Date

7-7-2025

Journal

Gastroenterology

DOI

10.1053/j.gastro.2025.06.025

PMID

40633624

PMCID

PMC12403438

PubMedCentral® Posted Date

9-3-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Background & aims: The increased 3-year incidence of pancreatic cancer after new-onset diabetes observed in retrospective studies needs prospective validation. It is unknown whether incidence varies by race and ethnicity.

Methods: In a prospective, observational study using active real-time surveillance of electronic health records, we identified 18,838 adults 50 years or older with glycemically defined new-onset diabetes (GNOD). In this interim analysis, we report 3-year Kaplan-Meier estimates of the proportion diagnosed with pancreatic cancer after GNOD (absolute incidence [95% CI]) and associated standardized incidence ratio (SIR) by race and ethnicity, overall 3-year incidence of pancreatic cancer adjusting for racial distribution of incident diabetes in the United States, and interval between GNOD and pancreatic cancer diagnosis.

Results: During median follow-up of 2.3 years, 82 pancreatic cancers were diagnosed (60% in men; mean [SD] age, 71 [8] years). The 3-year estimates for the proportion diagnosed with pancreatic cancer and associated SIR by race and ethnicity were as follows: non-Hispanic White patients (n = 6518): 0.84% (95% CI, 0.60%-1.07%) and 6.4 (95% CI, 4.8-8.4); Hispanic patients (n = 5984): 0.40% (95% CI, 0.20%-0.60%) and 4.2 (95% CI, 2.6-6.3); African American patients (n = 2192): 0.37% (95% CI, 0.07%-0.67%) and 2.4 (95% CI, 1.0-5.0), and Asian/Pacific Islander patients (n = 3360): 0.22% (95% CI, 0.06%-0.39%) and 3.0 (95% CI, 1.4-6.0). Overall, race-adjusted 3-year pancreatic cancer incidence was 0.62%. On average, GNOD occurred 8 months before clinical diagnosis (0-4 months in 30.5%, 4-12 months in 31.3%, 12-24 months in 19.5%, and 24-36 months in 18.7%).

Conclusions: GNOD, identifiable in real time using active surveillance of electronic health records, is associated with a high 3-year incidence of pancreatic cancer with marked racial and ethnic differences. Longer-term risk needs further study.

Keywords

HbA1c, screening, incident diabetes, pancreatic ductal adenocarcinoma, Black/African American, Hispanic/Latinx, Native American/Indigenous/American Indian, AAPI (Asian-American/Pacific Islander), White/Caucasian, Race/Racial, Bias, Disparities/Disparity/Disparate/Parity, Socioeconomic, Equity, Diverse/Diversity, Unequal, Equality, Equal, Gender, Inclusion, Status

Published Open-Access

yes

Recommended Citation

Chari, Suresh T; Wu, Bechien; Lopez, Camden; et al., "Risk of Pancreatic Cancer in Glycemically Defined New-Onset Diabetes: A Prospective Cohort Study" (2025). Faculty, Staff and Student Publications. 4805.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/4805