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Science Nook: Diabetes, Weight Change, and Risk of Pancreatic Cancer

Pancreatic cancer has a 5-year survival rate of less than 10% [Siegel et al., 2020 as cited in reference i], largely due to diagnosis at an advanced stage of cancer. This low survival rate and diagnosis at advanced stage indicate the importance of exploring early detection strategies. The below study looks at the associations between pancreatic cancer diagnosis, diabetes, and weight change, offering findings that may help guide future pancreatic cancer screening protocols.

Study

Diabetes, Weight Change, and Pancreatic Cancer Risk

Journal: JAMA Oncology

This prospective cohort study included over 150,000 participants from the Nurses’ Health Study and the Health Professionals Follow-Up Study. Participants have received follow-up questionnaires every 2 years since enrollment–1976 for the Nurses’ Health Study and 1986 for the Health Professionals Follow-Up Study. The authors looked at pancreatic cancer diagnosis and diabetes from the follow-up questionnaires and a supplementary questionnaire asking more details related to pancreatic cancer and diabetes diagnoses. Recent weight change was calculated using the biennial follow-up questionnaires, and categorized as: no weight loss, 1-4 lbs weight loss, 5-8 lbs weight loss, and more than 8 lbs weight loss [i].

Findings

The authors found:

1. Those with diabetes had an increased risk of pancreatic cancer

2. Those with more recent weight loss had an increased risk of pancreatic cancer

3. Those with recent-onset diabetes and recent weight loss had an increased risk of pancreatic cancer of more than 6 times

4. Of participants with recent-onset diabetes and recent weight loss, those 70 years or older, with a BMI of less than 25 before weight loss, and with a low likelihood of intentional weight loss from diet and exercise, had a further increased risk of pancreatic cancer [i]


For the Patient and Caregiver

The relationship found between recent-onset diabetes and recent weight loss prior to early-stage pancreatic cancer is likely due to “tumor-induced alterations in the metabolism of the host” [Khalaf et al., 2019 as cited in reference i]. In general, to decrease risk of chronic diseases such as cancers and diabetes, aim for intake of whole foods including vegetables, fruits, whole grains, legumes, nuts and seeds, and lean proteins, as well as a physically active lifestyle. For more information on lifestyle changes that may decrease risk of pancreatic cancer, take a look at this article.

For the Healthcare Team

“The US Preventive Services Task Force does not recommend screening for pancreatic cancer in individuals who are asymptomatic and have average risk” [Owens et al., 2019 as cited in reference i]. The authors suggest studying recent-onset diabetes, with unintentional weight loss, after age 50, as a component of pancreatic cancer surveillance. Another important factor to consider is how recent weight loss will be extrapolated from the findings of the present study and measured in a practical setting, as in the present study weight loss was looked at over 2 years.


Reference:

[i] Yuan C, Babic A, Khalaf N, Nowak JA, Brais LK, Rubinson DA…Wolpin BM. (2020). Diabetes, weight change, and pancreatic cancer risk. JAMA Oncology, E1-E9. doi:10.1001/jamaoncol.2020.2948

Jenna Koroly, MS, RD, CDN

Jenna is a Registered Dietitian with a Master’s of Science in Nutrition and Exercise Physiology from Teachers College, Columbia University. She has been a part of the Savor Health team since October 2016, and gained further clinical knowledge in oncology while performing nutrition assessments at Northern Westchester Hospital and Amsterdam Nursing Home as a dietetic intern. Jenna provides nutrition counseling for patients in Medical Weight Management and Bariatric Surgery settings at Brigham & Women's Hospital in Boston. She is passionate about nutrition therapy and exercise for oncology patients.

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