title: New-onset type 2 diabetes mellitus--A high-risk group suitable for the screening of pancreatic cancer?
abstract: BACKGROUND
  Type 2 diabetes mellitus is widely considered to be associated with pancreatic cancer.
  
  
  OBJECTIVE
  To determine the incidence of pancreatic cancer in new-onset type 2 diabetic patients by measuring the serum level of CA 19-9 and performing abdominal ultrasonography (US).
  
  
  METHODS
  Consecutive type 2 diabetic patients in whom diabetes was diagnosed within 36 months were included in this prospective study. Serum CA 19-9 measurement and US were performed in all patients. If any of two was positive, abdominal computer tomography (CT) was carried out. Endoscopic ultrasound-guided fine needle aspiration or direct surgical referral was performed on patients with CT-identified lesions.
  
  
  RESULTS
  A total of 115 patients were enrolled. CA 19-9 was elevated in 10 patients but pancreatic cancer diagnosed in neither of them. Pancreatic cancer was revealed by morphological means in three patients without elevated CA 19-9 level. The sensitivity, specificity, positive-, negative predictive values and validity were 0%, 90.4%, 0%, 97.9% and 87.9% for CA 19-9, 66.7%, 100%, 100%, 99% and 99% for US, respectively. The value of the Standardized Incidence Ratio for pancreatic cancer in new-onset type-2 diabetic patients was 198.6 (95% CI = 6.25-46.9).
  
  
  CONCLUSIONS
  The prevalence of pancreatic cancer in patients with new-onset type-2 diabetes is significantly higher than that in the general population and screening is beneficial for detecting PaC in this patient population. CA 19-9 and US is not reliable screening modality for pancreatic cancer screening in this population.
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Dóra
authors.initials: D
authors.lastname: Illés
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Viktória
authors.initials: V
authors.lastname: Terzin
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Gábor
authors.initials: G
authors.lastname: Holzinger
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Klára
authors.initials: K
authors.lastname: Kosár
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Richárd
authors.initials: R
authors.lastname: Róka
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Gábor
authors.initials: G
authors.lastname: Zsóri
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: György
authors.initials: G
authors.lastname: Ábrahám
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary. Electronic address: czako.laszlo@med.u-szeged.hu.
authors.forename: László
authors.initials: L
authors.lastname: Czakó
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018395:CA-19-9 Antigen / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics
chemical_list: D018395:CA-19-9 Antigen
keywords: Abdominal ultrasonography; Ca 19-9; Diabetes mellitus; Pancreatic cancer; Screening; Standardized incidence ratio