title: Diabetes and risk of pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium.
abstract: OBJECTIVE
  Diabetes is a suspected risk factor for pancreatic cancer, but questions remain about whether it is a risk factor or a result of the disease. This study prospectively examined the association between diabetes and the risk of pancreatic adenocarcinoma in pooled data from the NCI pancreatic cancer cohort consortium (PanScan).
  
  
  METHODS
  The pooled data included 1,621 pancreatic adenocarcinoma cases and 1,719 matched controls from twelve cohorts using a nested case-control study design. Subjects who were diagnosed with diabetes near the time (<2 years) of pancreatic cancer diagnosis were excluded from all analyses. All analyses were adjusted for age, race, gender, study, alcohol use, smoking, BMI, and family history of pancreatic cancer.
  
  
  RESULTS
  Self-reported diabetes was associated with a forty percent increased risk of pancreatic cancer (OR = 1.40, 95 % CI: 1.07, 1.84). The association differed by duration of diabetes; risk was highest for those with a duration of 2-8 years (OR = 1.79, 95 % CI: 1.25, 2.55); there was no association for those with 9+ years of diabetes (OR = 1.02, 95 % CI: 0.68, 1.52).
  
  
  CONCLUSIONS
  These findings provide support for a relationship between diabetes and pancreatic cancer risk. The absence of association in those with the longest duration of diabetes may reflect hypoinsulinemia and warrants further investigation.
authors.affiliation: Division of Cancer Control and Population Science, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA. elenajw@mail.nih.gov
authors.forename: Joanne W
authors.initials: JW
authors.lastname: Elena
authors.forename: Emily
authors.initials: E
authors.lastname: Steplowski
authors.forename: Kai
authors.initials: K
authors.lastname: Yu
authors.forename: Patricia
authors.initials: P
authors.lastname: Hartge
authors.forename: Geoffrey S
authors.initials: GS
authors.lastname: Tobias
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Brotzman
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Chanock
authors.forename: Rachael Z
authors.initials: RZ
authors.lastname: Stolzenberg-Solomon
authors.forename: Alan A
authors.initials: AA
authors.lastname: Arslan
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: Kathy
authors.initials: K
authors.lastname: Helzlsouer
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Jacobs
authors.forename: Andrea
authors.initials: A
authors.lastname: LaCroix
authors.forename: Gloria
authors.initials: G
authors.lastname: Petersen
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.forename: Demetrius
authors.initials: D
authors.lastname: Albanes
authors.forename: Naomi E
authors.initials: NE
authors.lastname: Allen
authors.forename: Laufey
authors.initials: L
authors.lastname: Amundadottir
authors.forename: Ying
authors.initials: Y
authors.lastname: Bao
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.forename: J Michael
authors.initials: JM
authors.lastname: Gaziano
authors.forename: Edward L
authors.initials: EL
authors.lastname: Giovannucci
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Duell
authors.forename: Göran
authors.initials: G
authors.lastname: Hallmans
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
authors.forename: David J
authors.initials: DJ
authors.lastname: Hunter
authors.forename: Amy
authors.initials: A
authors.lastname: Hutchinson
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Jacobs
authors.forename: Charles
authors.initials: C
authors.lastname: Kooperberg
authors.forename: Peter
authors.initials: P
authors.lastname: Kraft
authors.forename: Julie B
authors.initials: JB
authors.lastname: Mendelsohn
authors.forename: Dominique S
authors.initials: DS
authors.lastname: Michaud
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Phillips
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Alpa V
authors.initials: AV
authors.lastname: Patel
authors.forename: Leah
authors.initials: L
authors.lastname: Sansbury
authors.forename: Xiao-Ou
authors.initials: XO
authors.lastname: Shu
authors.forename: Michael S
authors.initials: MS
authors.lastname: Simon
authors.forename: Nadia
authors.initials: N
authors.lastname: Slimani
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Trichopoulos
authors.forename: Kala
authors.initials: K
authors.lastname: Visvanathan
authors.forename: Jarmo
authors.initials: J
authors.lastname: Virtamo
authors.forename: Brian M
authors.initials: BM
authors.lastname: Wolpin
authors.forename: Anne
authors.initials: A
authors.lastname: Zeleniuch-Jacquotte
authors.forename: Charles S
authors.initials: CS
authors.lastname: Fuchs
authors.forename: Robert N
authors.initials: RN
authors.lastname: Hoover
authors.forename: Myron
authors.initials: M
authors.lastname: Gross
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D048909:Diabetes Complications / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors