Inclusion criteria, exclusion criteria and study summary
At the time of diagnosis of pancreatic cancer, an estimated 65% of patients have diabetes mellitus (DM). Whilst a small proportion of DM in pancreatic cancer patients is long standing (present more than 3 years) the remainder is new-onset-DM. This often goes undiagnosed, and when it is diagnosed, in the majority of cases this comes within one year prior to pancreatic cancer being identified. In effect, new-onset diabetes can be an early warning sign of the presence of pancreatic cancer, and individuals with new-onset diabetes are a high-risk group for pancreatic cancer. Approximately 1% of individuals (1 in 100) diagnosed with new onset type 2 DM (T2DM) have undiagnosed pancreatic cancer. This group of individuals actually has pancreatic cancer associated DM, although it is mistakenly diagnosed as T2DM. Currently individuals with new-onset DM are not screened for pancreatic cancer as there are no reliable tests to distinguish between T2DM and pancreatic cancer associated DM. Developing methods for pancreatic cancer detection in individuals with new-onset DM will require early-stage, pre-diagnostic samples and corresponding patient data. In this study we aim to recruit 2500 Individuals from hospitals and GP surgeries who are 50 years old or over and newly diagnosed with DM. Blood samples and questionnaire/clinical data will be collected at appointments every six months for two years. We will collect and store samples in a standardised way so that they can be used to identify biomarkers in the blood that will distinguish between DM caused by pancreatic cancer and type 2 DM. This may ultimately enable a screening programme in the future. As part of this study we will also attempt to gain a better understanding of risk factors associated with pancreatic cancer and to determin the cost effectiveness of screening for pancreatic cancer.
