9O - Pancreatic cancer risk in individuals with newly diagnosed diabetes: Insights from the AMORIS cohort in Sweden

Background

Delayed diagnosis contributes to poor survival in pancreatic cancer (PC). Early detection may improve outcomes, but symptom-based diagnostic approaches are challenging, because most symptoms are non-specific and more likely to be associated with a non-cancer cause. Approximately forty percent of people diagnosed with PC have diabetes at the time of PC diagnosis. Few PC prediction models exist for this population, with limited performance and high risk of bias. We aim to refine performance in predicting PC in individuals diagnosed with type 2 diabetes by identifying and weighting commonly used routine blood markers, which could potentially enhance identification of individuals at high risk of PC in primary care with a simple blood test.

Methods

We identified individuals from the AMORIS cohort study with newly diagnosed diabetes based on the Swedish National Diabetes Registry and patient registry. Individuals aged 50 or older with type 2 diabetes were included. All participants presented a routine biomarker panel measured after diagnosis of diabetes, including liver enzymes, glucose and lipids profile, markers of inflammation and sugar metabolism. Possible confounding factors such as age, sex, and educational level were considered. Initial multivariate Cox proportional hazards analysis was conducted.

Results

A total population of 101,051 individuals with newly diagnosed diabetes were identified. 1390 PC events occurred during the follow up time (meanyears=25.38). Preliminary results identified increased risk of PC with higher total cholesterol (mmol/L) (HR (95%CI): 1.11 (1.03-1.19)) and Alkaline Phosphatase (ALP) (μkat/L) (HR (95%CI): 1.10 (1.05-1.16)) and lower albumin (g/L) (HR (95%CI): 0.95 (0.92-0.96)). Table: 9O

Multivariate biomarker panel continuous

Conclusions

Routine blood markers could be a non-invasive cost-effective avenue to identify diabetic patients at higher risk of PC and improve early detection. Work is ongoing to evaluate lag time, discrimination analysis and prediction scores.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

The authors.

Funding

Cancer Research UK and Pancreatic Cancer Research.

Disclosure

All authors have declared no conflicts of interest.