Screening adults with new-onset diabetes for pancreatic cancer may be effective for early diagnosis and treatment initiation, according to study data presented at the 52nd European Association for the Study of Diabetes Annual Meeting.
“[Diabetes/prediabetes] is much more frequent in patients with pancreatic cancer than in the general population,” Pavel Škrha, PhD, of the 2nd department of internal medicine, 3rd faculty of medicine at Charles University in Prague, told Endocrine Today. “New-onset [diabetes] — diagnosis preceding the cancer diagnosis by less than 2 years — can already be the first symptom of cancer and thus the first warning. Such diabetes can be classified as secondary [diabetes]. MicroRNA-196 and -200 could be once used together with CA 19-9 as a tool for screening pancreatic cancer.”
Škrha and colleagues evaluated 60 adults (mean age, 67 years) with pancreatic cancer and diabetes, 34 adults (mean age, 63 years) with type 2 diabetes without pancreatic cancer and 30 adult controls (mean age, 63 years) to determine the sensitivity and specificity of the biochemical marker cancer antigen (CA) 19-9 alone or with microRNA-196 and microRNA-200 to identify patients with pancreatic cancers.
“Higher detection of new-onset diabetes or prediabetes in pancreatic cancer could play an important role in the early diagnosis of this cancer, which has some of the worst outcomes of any cancer,” the researchers wrote. “Other signs, like weight loss and/or gastrointestinal symptoms, may initiate further examination.”
Needle biopsy or surgical resection of a tumor was used to confirm a pancreatic cancer diagnosis. American Diabetes Association criteria were used to diagnose diabetes or prediabetes.
Among participants with pancreatic cancer, 44 had new-onset diabetes and 16 had long-term diabetes, suggesting a stronger association between pancreatic cancer and new-onset diabetes compared with long-term diabetes.
All three biomarkers evaluated were elevated among participants with pancreatic cancer (P < .0001 for all). Sensitivity for CA 19-9 alone was 85% and specificity was 73%; when used in combination with microRNA-196 and microRNA-200, the sensitivity and specificity increased to 95% and 77%, respectively.
“We should be aware of newly diagnosed [diabetes], especially in patients, who are lean, who have lost weight, whose [diabetes] is worsening rapidly, etc.,” Škrha told Endocrine Today. “Further examination of pancreatic cancer should be performed in these cases. The markers need to be validated in larger studies, a prospective study with new-onset diabetic non-obese patients should be performed. Specificity of the markers should be tested by determining them in other malignancies.” – by Amber Cox
krha P, et al. Poster 572. Presented at: 52nd EASD Annual Meeting; Sept. 12-16, 2016; Munich.
Disclosure: krha reports no relevant financial disclosures.