Is type 2 diabetes mellitus a risk factor for gallbladder, biliary and pancreatic cancer?

There are minimal data assessing the relationship between diabetes with gallbladder, biliary and pancreatic cancer. Recent small studies have suggested an elevated risk of pancreatic cancer only in patients with diabetes mellitus (DM).

A research article published on 14 November in the World Journal of Gastroenterology addresses this question. The research team, lead by Dr Jamal at the Veterans Affairs Medical Centre, Long Beach, California, performed a retrospective search of type 2 DM patients matched to non-diabetic controls, discharged from Department of Veterans Affairs hospitals from 1990 to 2000, for the presence of gallbladder, biliary and pancreatic cancer. The database search identified 1 172 496 cases and control subjects for analysis. There was no difference in mean age between the case and control groups. Among patients with type 2 DM, the incidence of pancreatic cancer was increased threefold compared to controls, and gallbladder and extrahepatic biliary cancers were increased by twofold compared to controls.

This is the first study to provide a comprehensive assessment of the risk for gallbladder, biliary and pancreatic cancers in a large cohort of patients with type 2 DM. This study suggests future avenues for investigation to determine preventive measures and screening implementation strategies, to limit the impact of these tumours in the veteran as well as general type 2 DM population in the United States.