Evidence map›Paper›PMID 37474717›Full record

ArticleDigestive diseases and sciences2023

Diabetes Status and Pancreatic Cancer Survival in the Nationwide Veterans Affairs Healthcare System.

Natalia Khalaf, Jennifer Kramer, Yan Liu, Daniela Abrams, Hardeep Singh, Hashem El-Serag, Fasiha Kanwal

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Article in Digestive diseases and sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Natalia KhalafCenter for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA. natalia.khalaf@bcm.edu.ORCID 0000-0002-7585-6183
Jennifer KramerCenter for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
Yan LiuCenter for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
Daniela AbramsDepartment of Gastroenterology and Hepatology, University of Texas Medical Branch, Galveston, TX, USA.
Hardeep SinghCenter for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
Hashem El-SeragCenter for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
Fasiha KanwalCenter for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.

Funding

Tumor BiologyP30CA125123 · NCI · BAYLOR COLLEGE OF MEDICINE · PI Michael M Ittmann · 2007 to 2026
$73.9M
Tissue Analysis & Molecular Imaging CoreP30DK056338 · NIDDK · BAYLOR COLLEGE OF MEDICINE · PI James Versalovic · 2001 to 2026
$28.3M
Health informatics approaches to reduce missed opportunities in diagnosis of pancreatic cancerIK2HX003346 · VA · MICHAEL E DEBAKEY VA MEDICAL CENTER · PI Natalia Khalaf · 2022 to 2026
–
HSRD VA IK2 HX003346NCI NIH HHS P30 CA125123NIDDK NIH HHS P30 DK056338
6 · The paper itself

Abstract

backgroundLong-standing type 2 diabetes is a known risk factor for developing pancreatic cancer, however, its influence on cancer-associated outcomes is understudied.

aimsTo examine the associations between diabetes status and pancreatic cancer outcomes.

methodsWe identified patients diagnosed with pancreatic adenocarcinoma in the national Veterans Administration System from 2010 to 2018. We classified each patient by pre-cancer diagnosis diabetes status: no diabetes, new-onset diabetes (NOD) of ≤ 3 years duration, or long-standing diabetes of > 3 years duration. We used Cox proportional hazards models to examine the association between diabetes status and survival. We adjusted the models for age, race, sex, body mass index, tobacco, and alcohol use, coronary artery disease, hypertension, chronic kidney disease, year of cancer diagnosis, and cancer stage and treatment.

resultsWe identified 6342 patients diagnosed with pancreatic adenocarcinoma. Most had long-standing diabetes (45.7%) prior to their cancer diagnosis, 14.5% had NOD, and 39.8% had no diabetes. Patients with long-standing diabetes had 10% higher mortality risk compared to patients without diabetes after adjusting for sociodemographic factors and medical comorbidities (adjusted HR 1.10; 95% CI 1.03-1.16). This difference in mortality remained statistically significant after additionally adjusting for cancer stage and receipt of potentially curative treatment (adjusted HR 1.09; 95% CI 1.02-1.15). There was no significant difference in mortality between patients with NOD compared to those without diabetes.

conclusionsLong-standing but not new-onset diabetes is independently associated with increased mortality among patients with pancreatic cancer. This information has implication for prognostication and risk stratification among pancreatic cancer patients.

Indexed as

AdenocarcinomaDiabetes Mellitus, Type 2Pancreatic NeoplasmsVeteransDelivery of Health CareHumansProportional Hazards ModelsRisk FactorsEpidemiologyLong-standing diabetesNew-onset diabetesPancreatic adenocarcinomaPancreatic cancerSurvival

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.