Brief Article
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 14, 2009; 15(42): 5274-5278
Published online Nov 14, 2009. doi: 10.3748/wjg.15.5274
Diabetes mellitus as a risk factor for gastrointestinal cancer among American veterans
M Mazen Jamal, Eugene J Yoon, Kenneth J Vega, Mehrtash Hashemzadeh, Kenneth J Chang
M Mazen Jamal, Eugene J Yoon, Mehrtash Hashemzadeh, Division of Gastroenterology, Veterans Affairs (VA) Medical Center, Long Beach, CA 90822, United States
M Mazen Jamal, Eugene J Yoon, Kenneth J Chang, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, University of California, Irvine Medical Center, Orange, CA 92868, United States
Kenneth J Vega, Division of Gastroenterology, University of Florida/Jacksonville, Jacksonville, FL 32207, United States
Author contributions: Jamal MM and Yoon EJ contributed equally to this work; Jamal MM designed the research; Jamal MM, Yoon EJ and Vega KJ performed the research; Jamal MM, Hashemzadeh M and Chang KJ contributed analytic tools; Jamal MM, Vega KJ and Chang KJ analyzed the data; Jamal MM and Yoon EJ wrote the paper.
Correspondence to: M Mazen Jamal, MD, MPH, Division of Gastroenterology, Veterans Affairs (VA) Medical Center, 5901 E. 7th St. Long Beach, CA 90822, United States.
Telephone: +1-562-8265628 Fax: +1-562-8265097
Received: May 28, 2009
Revised: October 14, 2009
Accepted: October 21, 2009
Published online: November 14, 2009

AIM: To assess the risk of biliary and pancreatic cancers in a large cohort of patients with type 2 diabetes mellitus (DM).

METHODS: Eligibility for this study included patients with type 2 DM (ICD-9 code 250.0) who were discharged from Department of Veteran Affairs hospitals between 1990 and 2000. Non-matched control patients without DM were selected from the same patient treatment files during the same period. Demographic information included age, sex and race. Secondary diagnoses included known risk factors based on their ICD-9 codes. By multivariate logistic regression, the occurrence of biliary and pancreatic cancer was compared between case subjects with DM and controls without DM.

RESULTS: A total of 1 172 496 case and control subjects were analyzed. The mean age for study and control subjects was 65.8 ± 11.3 and 64.8 ± 12.6 years, respectively. The frequency of pancreatic cancer in subjects with DM was increased (0.9%) in comparison to control subjects (0.3%) with an OR of 3.22 (95% CI: 3.03-3.42). The incidence of gallbladder and extrahepatic biliary cancers was increased by twofold in diabetic patients when compared to controls. The OR and 95% CI were 2.20 (1.56-3.00) and 2.10 (1.61-2.53), respectively.

CONCLUSION: Our study demonstrated that patients with DM have a threefold increased risk for developing pancreatic cancer and a twofold risk for developing biliary cancer.

Keywords: Diabetes mellitus, Pancreatic neoplasms, Adenocarcinoma, Gallbladder neoplasms