New-onset diabetes patients need pancreatic cancer screening?

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/m(2), 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.