title: [Pancreatic cancer--association with diabetes mellitus and smoking].
abstract: BACKGROUND
  Pancreatic cancer is a disease with rather poor prognosis. This can be explained, among other reasons, by unusually aggressive course of the tumour growth and, in the majority of cases, late, and thus further treatment limiting, diagnosis. In addition, no effective screening programme for pancreatic cancer is available and thus identification of risk factors associated with the development of pancreatic cancer represents a possible approach to diagnosing early stages of the disease. Smoking represents a general and diabetes mellitus a specific risk factor for pancreatic cancer. The aim of our prospective study in pancreatic cancer patients was to identify patients with diabetes mellitus and divide these into smokers and non-smokers--in association with the diagnosis of pancreatic carcinoma.
  
  
  METHODS
  We included 83 patients, 50 men and 33 women, with pancreatic cancer who were divided into 3 groups--non-smokers with diabetes mellitus, smokers and smokers with diabetes mellitus; the mean age was 64.2 years in male and 59.8 years in female patients. Pancreatic cancer was confirmed histomorphologically from pancreatic biopsies or a histology of pancreatic tissue obtained during a surgery.
  
  
  RESULTS
  Pancreatic cancer was diagnosed after 3 or more years in patients with diabetes mellitus, the majority of diagnoses in smokers were made within the first year from the first dyspeptic symptoms. We found that the proportion of patients with subsequent diagnosis of pancreatic cancer increased with the number of cigarettes smoked per day (33.3% up to 10 cigarettes per day and 66.5% over 10 cigarettes per day). The highest incidence of pancreatic cancer, in 42 persons (50.6%), was associated with concurrent diabetes and smoking.
  
  
  CONCLUSIONS
  Pancreatic cancer was identified in 24% of patients with diabetes mellitus, 25.3% of smokers with no diabetes and in more than 50% of smokers with diabetes mellitus. We assume that smoking is an independent risk factor for pancreatic cancer induction and it importantly increases the risk of pancreatic cancer in patients with diabetes mellitus.
authors.affiliation: Interní gastroenterologická klinika Lékarské fakulty MU a FN Brno. pdite@fnbrno.cz
authors.forename: P
authors.initials: P
authors.lastname: Díte
authors.forename: J
authors.initials: J
authors.lastname: Trna
authors.forename: J
authors.initials: J
authors.lastname: Belobrádková
authors.forename: I
authors.initials: I
authors.lastname: Novotný
authors.forename: M
authors.initials: M
authors.lastname: Hermanová
authors.forename: P
authors.initials: P
authors.lastname: Vlcková
authors.forename: K
authors.initials: K
authors.lastname: Klímová
authors.forename: B
authors.initials: B
authors.lastname: Kianicka
authors.forename: Abdul
authors.initials: A
authors.lastname: Lemine
authors.forename: M
authors.initials: M
authors.lastname: Liberda
authors.forename: E
authors.initials: E
authors.lastname: Geryk
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology*; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*