Patients with Type 2 diabetes have a three-fold increased risk for pancreatic cancer and a two-fold increased risk for biliary cancer, report researchers.

“Even though cardiovascular complications are a major cause of morbidity and mortality in patients with diabetes, this disease has also been associated with several cancers, most notably of the liver, endometrium, kidney, and pancreas,” say M Mazen Jamal (Veterans Affairs Medical Center, Long Beach, California, USA) and colleagues.

In this study, the researchers assessed the frequency of biliary and pancreatic cancers in 278,761 patients with a diagnosis of Type 2 diabetes (ICD-9 code 250.0) and 836,283 controls. The participants were aged an average of 65.3 years and 97.6% were male.

The data was obtained from the Austin Automation Center which has maintained the Patient Treatment File, containing data from all Veterans Health Administration hospitals, since 1969.

Writing in the World Journal of Gastroenterology, the authors report that following multivariate analysis, individuals with Type 2 diabetes were 3.22 times more likely to have pancreatic cancer than controls, at a frequency of 0.9% versus 0.3%.

In addition, diabetic patients were 2.20 and 2.10 times more likely to have gallbladder and extrahepatic biliary cancers, respectively, when compared with controls.

These associations were independent of other known risk factors such as cholelithiasis, pancreatitis, obesity, and smoking.

The results of this study “should further heighten our awareness of the many complications associated with insulin resistance and modify the intensity of our approach to these patients,” conclude Jamal et al.

“This could warrant a keener eye by the primary care physician for any abnormalities in his or her diabetic patients, which indicate the possibility of cardiovascular, renal and ophthalmic complications, as well as the rare but foreseeable possibility of a fatal pancreaticobiliary malignancy.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

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