New Risk-Prediction Model Offers Hope for Earlier Detection of Pancreatic Cancer

Patients diagnosed with pancreatic cancer can develop elevated blood sugar levels up to three years before their cancer diagnosis, according to the results of a study by Mayo Clinic researchers who published their results in Gastroenterology.

"Pancreatic cancer is rapidly fatal after its diagnosis, with average survival of six months," says Suresh Chari, M.D., a gastroenterologist at Mayo Clinic. "It has also been thought that its course prior to diagnosis is also rapid and that early detection is not feasible. But our studies provide hope that pancreatic cancer can indeed be diagnosed at an earlier stage when it is resectable."

In the first study, researchers plotted blood sugars levels of patients with pancreatic cancer going back five years prior to diagnosis. They also plotted the blood sugars of a control group who were matched by age and gender to those with pancreatic cancer. Researchers showed that blood sugars rise 30 to 36 months before the diagnosis of cancer.

Tracking the blood sugar levels of nearly 600 patients with pancreatic cancer just prior to surgical removal of the cancer was also revealing. Researchers grouped these patients by their tumor volume at the time of surgical removal. "In this group, we were able to show that blood sugars rise commensurate with the increasing volume of the tumor. Patients with tumors that were very small, less than one cubic centimeter in volume, had lower blood sugars than patients with larger tumors," Dr. Chari says.

Identifying those at risk of developing pancreatic cancer

A risk-prediction model was also developed, which identifies patients with new onset diabetes who are at a very high risk of developing pancreatic cancer. These findings are significant because they represent a potential new way to diagnose pancreatic cancer at an earlier stage, according to the researchers.

The model, called an ENDPAC score, identifies a subset of patients with new onset diabetes that have a thirty- to forty-fold higher risk of having pancreatic cancer. "Among these patients, the risk of having pancreatic cancer is between four and seven percent," says Dr. Chari. "We believe that if these findings are validated, patients who have a high blood sugar and a high ENDPAC score should be thoroughly tested for pancreatic cancer."

This article has been republished from materials provided by Mayo Clinic. Note: material may have been edited for length and content. For further information, please contact the cited source.

Reference:

Sharma, A., Kandlakunta, H., Nagpal, S. J., Ziding, F., Hoos, W., Petersen, G. M., & Chari, S. T. (2018). Model to Determine Risk of Pancreatic Cancer in Patients with New-onset Diabetes. Gastroenterology. doi:10.1053/j.gastro.2018.05.023