title: Long-Term Diabetes Mellitus Is Associated with an Increased Risk of Pancreatic Cancer: A Meta-Analysis.
abstract: OBJECTIVE
  Previous studies have shown a bidirectional relationship between diabetes and pancreatic cancer (PC). In particular, new-onset diabetes might be induced by PC, and people with long-term diabetes might be at increased risk for the development of PC. The purpose of our study was to examine whether long-term diabetes represented an independent risk factor for PC development.
  
  
  METHODS
  A literature search was performed by searching electronic databases for studies published before July 1, 2014, and relative risks (RRs) and corresponding 95% confidence intervals (CIs) were calculated. Data pertaining to diabetes were recorded at both individual and study levels, with RRs calculated separately to analyze the relationship between the duration of diabetes and the development of PC.
  
  
  RESULTS
  Forty-four studies were included in this meta-analysis, including 18 studies with a case-control design, 5 with a nested case-control design and 21 with a cohort design. The overall summary estimate for the relationship between the population with a duration of diabetes ≥2 years and PC was 1.64 (1.52-1.78). The pooled RR (95% CI) of PC for the population with a duration of diabetes ≥5 years was 1.58 (1.42-1.75). For the population with a duration of diabetes ≥10 years, the RR (95% CI) of PC was 1.50 (1.28-1.75).
  
  
  CONCLUSIONS
  Our study suggests that long-term diabetes mellitus is associated with an increased risk of PC. However, the level of risk is negatively correlated with increasing diabetes mellitus duration.
authors.affiliation: Department of Pancreas and Breast Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Song
authors.affiliation: Department of Pancreas and Breast Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Baosheng
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Pancreas and Breast Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Pancreas and Breast Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Liliang
authors.initials: L
authors.lastname: Hao
authors.affiliation: Department of Pancreas and Breast Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Xianliang
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Pancreas and Breast Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Zhongxiang
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Pancreas and Breast Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Shaolong
authors.initials: S
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000209:etiology*; D018570:Risk Assessment; D012307:Risk Factors