Approved research

The Identification of patients at risk in screening for sporadic pancreatic cancer

Lay summary

Pancreatic cancer (PaC) is associated with poor outcome and remains the fourth most common cause of cancer-related death. The majority of PaC cases present at an advanced, incurable stage; therefore earlier detection is key to improving survival. There is evidence demonstrating that new-onset diabetes (NODM) frequently precedes PaC diagnoses, suggesting that NODM is an early warning sign of PaC. Study aims: 1.To determine whether NODM is a useful biomarker for detection of early PaC 2.To establish a successful double-sieved screening protocol for PaC, where patients are initially screened for NODM and then using established molecular markers and imaging modalities. PaC is an increasing health problem with significant impact on national health system. The incidence of PaC is rising, yet there is no significant improvement in survival after treatment. Patients with early stage PaC can have improved long term outcome after surgery. However, due to a relatively low incidence, screening the general population for sporadic PaC would be uneconomical. Thus a screening protocol for PaC is not yet available. The results of this epidemiological study could help to shape a targeted screening programme for sporadic PaC. This would result in earlier detection of PaC and improved patient survival. We plan to utilise the UK Biobank?s data on PaC patients? glucose levels, measured prior to their diagnosis. By comparing these patients' glucose level or diabetic status to healthy nested controls, we aim to define a relationship between NODM and PaC taking into account all possible confounders (such as diet,life style etc). In order to establish a relationship between NODM and PaC, a case control study is proposed. We will aim to use all the available PaC cases and match them in 1:2 fashion to nested healthy control individuals.