Impact of race, sex and age on the probability of pancreatic cancer among patients with newly diagnosed diabetes in a claims-based cohort
Objective Pancreatic cancer diagnoses are frequently preceded by a new diabetes diagnosis. Screening individuals newly diagnosed with diabetes could enable the earlier detection of pancreatic cancer. We sought to estimate the risk of pancreatic cancer by age, sex, race and time since diabetes diagno...
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BMJ Publishing Group
2025-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/5/e099488.full |
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| author | Michael Goggins Bryan Lau Elham Afghani Laura K Becker Alison P Klein |
| author_facet | Michael Goggins Bryan Lau Elham Afghani Laura K Becker Alison P Klein |
| author_sort | Michael Goggins |
| collection | DOAJ |
| description | Objective Pancreatic cancer diagnoses are frequently preceded by a new diabetes diagnosis. Screening individuals newly diagnosed with diabetes could enable the earlier detection of pancreatic cancer. We sought to estimate the risk of pancreatic cancer by age, sex, race and time since diabetes diagnosis.Design Claims-based cohort study.Setting Johns Hopkins Medicine conducted this deidentified claims-based cohort study using the Optum Labs Data Warehouse.Participants Insurance enrollees from 1/2008–9/2018 were identified as non-diabetic or newly diagnosed diabetic. Our risk set included 4 732 313 individuals (424 129 newly diabetic) in 5 844 934 enrolment periods.Primary outcome measures Time to pancreatic cancer. Diabetes and cancer were defined using International Classification of Diseases (ICD)-9/10 codes.Results Individuals with newly diagnosed diabetes were at an increased HR of pancreatic cancer, but this effect waned over time. The HR of pancreatic cancer following a diabetes diagnosis was higher in younger individuals and varied by race (lower HR in non-White individuals) (p<0.01, main effects and interactions). Thus, the probability of pancreatic cancer following a diabetes diagnosis was dependent on age, race and sex. For example, the 1-year probability of pancreatic cancer in a White male aged 75 was 0.45% (95%CI 0.41% to 0.49%) if they were newly diagnosed with diabetes and 0.090% (95%CI 0.084% to 0.096%) if they were free of diabetes. In contrast, the risk was lower at 0.15% (new-diabetic, 95% CI 0.13% to 0.16%) and 0.022% (diabetes free, 95%CI 0.020% to 0.023%) at age 55. The HR of pancreatic cancer for individuals with newly diagnosed diabetes compared with those free of diabetes was highest in the month following diagnosis (HR=14.7 and 9.6 for a 55 and 75 year old White male, respectively) but decreased in the following months, with a HR of 7.8 and 5.8 at 3 months, 5.6 and 4.1 at 6 months, and 3.9 and 2.8 at 1 year (p<0.01).Conclusions Consideration of the age–race–sex specific probability of pancreatic cancer and time since diabetes diagnosis is necessary when evaluating the risk of pancreatic cancer following a diabetes diagnosis. |
| format | Article |
| id | doaj-art-8fdc8d354a7e40f3bf4992505fcc401e |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-8fdc8d354a7e40f3bf4992505fcc401e2025-08-20T03:12:19ZengBMJ Publishing GroupBMJ Open2044-60552025-05-0115510.1136/bmjopen-2025-099488Impact of race, sex and age on the probability of pancreatic cancer among patients with newly diagnosed diabetes in a claims-based cohortMichael Goggins0Bryan Lau1Elham Afghani2Laura K Becker3Alison P Klein4Division of Gastroenterology, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD, USADepartment of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USADivision of Gastroenterology, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD, USAOptumLabs, Eden Prairie, Minnesota, USADivision of Gastroenterology, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD, USAObjective Pancreatic cancer diagnoses are frequently preceded by a new diabetes diagnosis. Screening individuals newly diagnosed with diabetes could enable the earlier detection of pancreatic cancer. We sought to estimate the risk of pancreatic cancer by age, sex, race and time since diabetes diagnosis.Design Claims-based cohort study.Setting Johns Hopkins Medicine conducted this deidentified claims-based cohort study using the Optum Labs Data Warehouse.Participants Insurance enrollees from 1/2008–9/2018 were identified as non-diabetic or newly diagnosed diabetic. Our risk set included 4 732 313 individuals (424 129 newly diabetic) in 5 844 934 enrolment periods.Primary outcome measures Time to pancreatic cancer. Diabetes and cancer were defined using International Classification of Diseases (ICD)-9/10 codes.Results Individuals with newly diagnosed diabetes were at an increased HR of pancreatic cancer, but this effect waned over time. The HR of pancreatic cancer following a diabetes diagnosis was higher in younger individuals and varied by race (lower HR in non-White individuals) (p<0.01, main effects and interactions). Thus, the probability of pancreatic cancer following a diabetes diagnosis was dependent on age, race and sex. For example, the 1-year probability of pancreatic cancer in a White male aged 75 was 0.45% (95%CI 0.41% to 0.49%) if they were newly diagnosed with diabetes and 0.090% (95%CI 0.084% to 0.096%) if they were free of diabetes. In contrast, the risk was lower at 0.15% (new-diabetic, 95% CI 0.13% to 0.16%) and 0.022% (diabetes free, 95%CI 0.020% to 0.023%) at age 55. The HR of pancreatic cancer for individuals with newly diagnosed diabetes compared with those free of diabetes was highest in the month following diagnosis (HR=14.7 and 9.6 for a 55 and 75 year old White male, respectively) but decreased in the following months, with a HR of 7.8 and 5.8 at 3 months, 5.6 and 4.1 at 6 months, and 3.9 and 2.8 at 1 year (p<0.01).Conclusions Consideration of the age–race–sex specific probability of pancreatic cancer and time since diabetes diagnosis is necessary when evaluating the risk of pancreatic cancer following a diabetes diagnosis.https://bmjopen.bmj.com/content/15/5/e099488.full |
| spellingShingle | Michael Goggins Bryan Lau Elham Afghani Laura K Becker Alison P Klein Impact of race, sex and age on the probability of pancreatic cancer among patients with newly diagnosed diabetes in a claims-based cohort BMJ Open |
| title | Impact of race, sex and age on the probability of pancreatic cancer among patients with newly diagnosed diabetes in a claims-based cohort |
| title_full | Impact of race, sex and age on the probability of pancreatic cancer among patients with newly diagnosed diabetes in a claims-based cohort |
| title_fullStr | Impact of race, sex and age on the probability of pancreatic cancer among patients with newly diagnosed diabetes in a claims-based cohort |
| title_full_unstemmed | Impact of race, sex and age on the probability of pancreatic cancer among patients with newly diagnosed diabetes in a claims-based cohort |
| title_short | Impact of race, sex and age on the probability of pancreatic cancer among patients with newly diagnosed diabetes in a claims-based cohort |
| title_sort | impact of race sex and age on the probability of pancreatic cancer among patients with newly diagnosed diabetes in a claims based cohort |
| url | https://bmjopen.bmj.com/content/15/5/e099488.full |
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