PLoS ONE: Pancreatic cancer can be diagnosed up to three years in advance

A new study suggests that pancreatic cancer can be diagnosed
three years earlier than the current diagnosis.
Weight loss and elevated blood sugar levels are early indicators of pancreatic cancer and may lead to a more timely diagnosis that can help improve survival
.

In the largest study of its kind, researchers from the University of Surrey, in collaboration with Pancreatic Cancer Action and the University of Oxford, investigated signs of pancreatic cancer, including weight loss, high blood sugar and diabetes, and demonstrated a timeline
of how these symptoms relate to cancer development.
The pancreas is an important organ with two key functions, producing insulin and digestive enzymes
.
Cancer affects one or both of these functions, causing the symptoms
described above.
Currently, almost 90% of pancreatic cancer patients are diagnosed too late for curative treatment
.

Lead author Dr Agnieszka Lemanska, a lecturer in data science at the University of Surrey, said:

"Because of the difficulty of detecting pancreatic cancer, survival rates for pancreatic cancer are very low compared to other cancers, with less than 10 percent of people surviving for 5 years or more
after diagnosis.

"Weight loss and elevated blood sugar are recognized symptoms of
pancreatic cancer.
However, the extent and timing of
these symptoms has been unknown.
Knowing when they appear will help clinicians diagnose this deadly cancer, which means treatment
can be started earlier.
”

Pancreatic cancer survivor Ali Stunt, founder and CEO of Pancreatic Cancer Initiative, said:

"I was lucky to be diagnosed in time before surgery and 'overcame the odds', but sadly, not everyone did
.
The symptoms of pancreatic cancer are unclear and difficult for clinicians to diagnose; At first I thought I had gallstones
.

"I'm one of the few people who survives pancreatic cancer for more than 10 years, and it's a lonely place
.
"

Using the Digital Centre for Clinical Information (ORCHID) at the Royal College of General Practitioners in Oxford, the researchers analysed data from 8777 patients diagnosed with pancreatic cancer and compared
it to 34979 controls.

The researchers found that pancreatic cancer patients lost
significantly weight two years before they were formally diagnosed.
At diagnosis, pancreatic cancer patients had a maximum body index (BMI) 3 lower than the control group
.
Elevated glycosylated hemoglobin (HbA1c) was detected even earlier, as early as three years
before diagnosis.

Further statistical analysis showed that diabetic patients had a higher risk of weight loss and pancreatic cancer than non-diabetic patients
.
The study also found that hyperglycemia patients without diabetes had a higher
risk of pancreatic cancer compared to those with diabetes.

Professor Simon de Lusignan of the University of Oxford explains:

"Our study suggests that high vigilance
should be exercised in unexplained significant weight loss, mainly in diabetic patients, but also in non-diabetic patients, and in patients with unexplained hyperglycemia.
"

The study's findings prompted researchers to call on clinicians to perform more regular BMI and glycosylated hemoglobin (HbA1c) assessments
in diabetics and non-diabetics.
This will help identify pancreatic cancer patients
.

Professor de Lusignan added:

"In clinical practice, BMI and glycated hemoglobin are simple indicators
of routine collection.
However, the challenge for research is that BMI and HbA1c detection are irregular and data are missing
.
For example, we found that people who were not diagnosed with diabetes rarely recorded BMI and HbA1c
compared to people with diabetes.
A data-driven approach can be an important tool
to help clinicians identify at-risk patients.
However, this relies on the quality and integrity of
the data.
Regular measurement of glycated hemoglobin and BMI in primary care not only improves the diagnosis of diabetes and pancreatic cancer, but also improves the quality of
data from routine studies.
”

Dr.
Lemanska said:

"A few years before a patient is diagnosed with pancreatic cancer, their weight drops significantly and their blood sugar rises
significantly.
This makes these metabolic changes important candidates for
pancreatic cancer markers.
However, because diabetes is much more prevalent than pancreatic cancer, it is difficult to identify hyperglycemia
caused by pancreatic cancer in clinical practice.
”

The study was published in
PLoS Synthesis.