Middle-aged men with type 2 diabetes as potential candidates for pancreatic cancer screening: a 10-year nationwide population-based cohort study

Abstract

Aims Before developing a national screening program for pancreatic cancer, more detailed and reliable estimation of pancreatic cancer incidence rate is needed according to sex, age, and diabetes mellitus status. Methods Among populations who underwent a biennial or annual evaluation provided by the National Health Insurance Service Database of Claims between 2006 and 2015, data were evaluated from the medical records of 34.2 million individuals aged 30 years and over. Results The annual incidence rate (IR; per 100,000) of pancreatic cancer in 2006 was 5.96, and the IR in 2015 increased to 8.92. The IRs increased consistently and significantly with age (p for trend < 0.0001). The incidence rate ratio (IRR; after adjusting for age and sex) of pancreatic cancer was higher (about 1.5 times) in males than in females for all ages. In particular, the IR (15.8) of pancreatic cancer between 50 and 59 years in patients with diabetes was strikingly higher compared to that in patients without diabetes (IR 7.6). Furthermore, the pancreatic cancer IR (19.1) of men with diabetes between 50 and 59 years was similar to the IR (20.2) in women with diabetes between 60 and 69 years, and it was even greater than the IR (17.0) in non-diabetic women between 60 and 69 years. Conclusions In middle-aged populations, men with type 2 diabetes had the highest relative risk. Their annual incidence rate of pancreatic cancer persistently increased and was higher by about 10-30% than in women with diabetes.