Family History of Diabetes and Pancreatic Cancer

Objectives: The aim of this study was to clarify the relationship between a family history of diabetes and pancreatic cancer.

Methods: We reviewed the records of 331 patients with pancreatic ductal cancer and information about a family history of diabetes in first-degree relatives. They were classified into 2 groups: patients with a family history of diabetes (group FH: 43 cases) and those without (group non-FH: 288 cases). Their clinical characteristics were compared. Each group was further divided into 2 subgroups according to the presence of long-standing diabetes for at least 3 years before the diagnosis of the pancreatic cancer, and the 2 subgroups were also compared.

Results: As compared with group non-FH, group FH was 4 years younger at the diagnosis of pancreatic cancer (61.33 +/- 9.00 vs. 65.46 +/- 10.48 years; P = 0.015) and showed a significant predilection for cancer of the pancreas body and/or tail (65.1% vs. 43.4%; P = 0.009). In group FH, patients with long-standing diabetes more often had nontubular type carcinoma than those without (44.4% vs. 0%; P = 0.007). However, no differences were seen between subgroups of group non-FH.

Conclusions: These findings suggest that pancreatic cancer patients with a family history of diabetes have different clinical characteristics compared with those without. The high rate of atypical histology seen in patients with a positive family history and preexisting diabetes might indicate a separate pathway for tumorigenesis in such patients.