Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

Body mass index, blood tests, comorbidities and medication use are temporally associated with cancer risk in the three years before a pancreatic cancer diagnosis.

Pancreatic ductal adenocarcinoma (PDAC) is challenging to diagnose due to the frequently vague and late-presenting symptoms of this disease, often leading to late diagnosis. A greater understanding of the risk factors for PDAC would aid earlier diagnosis, increasing the likelihood of better outcomes for patients with PDAC.

While some clinical factors such as new-onset Type 2 diabetes have been associated with an increased risk of PDAC diagnosis, the sheer numbers of people affected by these risk factors (e.g. 200,000 new diagnoses of Type 2 diabetes per year in England) mean that screening would not be practical in this population. Further enrichment of people at higher PDAC risk would help to identify the population who could benefit most from screening.

A team of researchers from the University of Oxford led by Professor Julia Hippisley-Cox (Nuffield Department of Primary Care and Health Sciences) and Dr Shivan Sivakumar (Department of Oncology) have studied how PDAC risk factors vary over time leading up to a PDAC diagnosis. Using the QResearch population-level electronic healthcare database, the body mass index (BMI), blood-based markers, comorbidities and medication use of 28,137 people before their PDAC diagnosis were compared with these factors in 261,219 matched controls.

In a paper published in the journal Gut, the researchers found that the risk of PDAC increased with higher blood levels of glucose, liver function markers, white blood cells and platelets, while both very low and very high BMIs and blood haemaglobin levels were associated with increased PDAC risk.

Looking over time, BMI decreased and blood glucose increased gradually 2-3 years before a PDAC diagnosis, with more rapid changes in the 1-2 years prior to PDAC. By contrast, liver markers, white blood cells and platelets were reasonably stable in the 2-3 years before diagnosis but showed rapid increases ~1 year prior to diagnosis. The highest risk of PDAC was associated with a recent diagnosis of a pancreatic cyst, pancreatitis, Type 2 diabetes and starting on certain glucose-lowering and acid-regulating therapies.

This enhanced knowledge about how PDAC risk factors vary over time prior to diagnosis could be combined into future risk prediction tools to identify people at an increased PDAC risk. In the future, this population with higher risk level could then be targeted for further investigation to aid earlier PDAC diagnosis.

Similar stories

Scientists find genetic ‘marker’ linked to serious side-effects from skin cancer treatment

New research from the Fairfax Group has identified a genetic marker that could be used to predict a patient’s risk of developing serious side-effects when undergoing immunotherapy treatment for metastatic melanoma.

Oxford gets £122m funding for healthcare research

Health and care research in Oxford is to receive £122 million in government funding over the next five years to improve diagnosis, treatment and care for NHS patients. The funding was awarded to the city’s two National Institute for Health and Care Research (NIHR) Biomedical Research Centres (BRC).

The Department represented at the European Radiation Research Society annual conference

Researchers from the Department of Oncology attend the prestigious European Radiation Research Society (ERRS) in annual conference in Catania, Italy to present their research in Radiation Oncology.

Funding to research metformin’s ability to delay or prevent cancers driven by the mutated TP53 gene

A research project embedded within the Metformin in Li Fraumeni (MILI) trial will investigate metformin’s mechanism of action when taken as a preventative for mTP53-driven cancers.

Cancer patients remain at higher risk of severe COVID-19 disease despite third dose booster vaccine

A large population-level assessment reveals third dose COVID-19 vaccination is effective for most patients with cancer, but effectiveness is lower than in the general population, particularly in patients who have undergone recent chemotherapy and those with lymphoma.

Population-scale study highlights ongoing risk of COVID-19 in some cancer patients despite vaccination

COVID-19 vaccination is effective in most cancer patients, but the level of protection against COVID-19 infection, hospitalisation and death offered by the vaccine is less than in the general population and vaccine effectiveness wanes more quickly.