Diabetes Among Finnish Pancreatic Cancer Patients: Prevalence, Time Interval Between Diabetes and Cancer Diagnosis, and Overall Survival.
- 1Department of Gastroenterological Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- 2Translational Cancer Medicine Research Program, iCAN Digital Precision Cancer Medicine Flagship, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
- 3Department of Diagnostics and Intervention/Surgery, Umeå University, Umeå, Sweden.
Abstract
Introduction
New-onset diabetes (NOD) potentially associated with pancreatic cancer (PC) requires further investigation to assess its potential as a tool for PC screening.Material and methods
In this longitudinal nationwide register study, which includes 14,712 PC patients and 18 years of follow-up time (2000-2018), we aimed to assess the prevalence of diabetes by using a large national registry. Survival was analyzed according to diabetes status and duration (long-term diabetes, i.e., DM diagnosed > 3 years prior to PC, NOD, i.e., DM diagnosed 0-3 years prior to PC, or DM diagnosed after PC diagnosis) and treatment status (curative intent vs. palliative) using multivariable Cox regression analysis.Results
Overall, 18% of PC patients had diabetes. The median time interval between DM and PC diagnoses was 4.8 months. In the multivariable Cox regression analysis, only DM diagnosed after PC was associated with worse survival, both in the palliative intent treatment group (HR 1.12, 95% CI 1.03-1.23, p = 0.011) and in the curative intent treatment group (HR 1.44, 95% CI 1.14-1.81, p = 0.002). Among patients diagnosed with diabetes prior to PC, neither long-term nor NOD significantly affected survival.Conclusions
Most of the diabetic PC-patients have been diagnosed with DM within a close proximity of cancer diagnosis. The progression from diabetes to clinically detectable cancer seems to be rapid-less than 6 months. Given the aggressive nature of PC and the fact that NOD can be an early sign, screening may need to begin at the time of diabetes diagnosis. The fact that a DM diagnosis made after a PC diagnosis is associated with worse survival may suggest that pancreatic tumors that cause hyperglycemia are particularly aggressive.
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BibTeX
@article{roosa2026diabetes,
title = {{Diabetes Among Finnish Pancreatic Cancer Patients: Prevalence, Time Interval Between Diabetes and Cancer Diagnosis, and Overall Survival.}},
author = {Suitiala Roosa and Aaltonen Panu and Mustonen Harri and Sund Malin and Seppänen Hanna},
journal = {Cancer medicine},
year = {2026},
month = oct,
doi = {10.1002/cam4.72380},
url = {https://europepmc.org/article/MED/42897094},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Diabetes Among Finnish Pancreatic Cancer Patients: Prevalence, Time Interval Between Diabetes and Cancer Diagnosis, and Overall Survival.
AU - Suitiala Roosa
AU - Aaltonen Panu
AU - Mustonen Harri
AU - Sund Malin
AU - Seppänen Hanna
PY - 2026
DA - 2026/10/01
JO - Cancer medicine
DO - 10.1002/cam4.72380
UR - https://europepmc.org/article/MED/42897094
AB - Introduction New-onset diabetes (NOD) potentially associated with pancreatic cancer (PC) requires further investigation to assess its potential as a tool for PC screening.Material and methods In this longitudinal nationwide register study, which includes 14,712 PC patients and 18 years of follow-up time (2000-2018), we aimed to assess the prevalence of diabetes by using a large national registry. Survival was analyzed according to diabetes status and duration (long-term diabetes, i.e., DM diagnosed > 3 years prior to PC, NOD, i.e., DM diagnosed 0-3 years prior to PC, or DM diagnosed after PC diagnosis) and treatment status (curative intent vs. palliative) using multivariable Cox regression analysis.Results Overall, 18% of PC patients had diabetes. The median time interval between DM and PC diagnoses was 4.8 months. In the multivariable Cox regression analysis, only DM diagnosed after PC was associated with worse survival, both in the palliative intent treatment group (HR 1.12, 95% CI 1.03-1.23, p = 0.011) and in the curative intent treatment group (HR 1.44, 95% CI 1.14-1.81, p = 0.002). Among patients diagnosed with diabetes prior to PC, neither long-term nor NOD significantly affected survival.Conclusions Most of the diabetic PC-patients have been diagnosed with DM within a close proximity of cancer diagnosis. The progression from diabetes to clinically detectable cancer seems to be rapid-less than 6 months. Given the aggressive nature of PC and the fact that NOD can be an early sign, screening may need to begin at the time of diabetes diagnosis. The fact that a DM diagnosis made after a PC diagnosis is associated with worse survival may suggest that pancreatic tumors that cause hyperglycemia are particularly aggressive.
SN - 2045-7634
ER -