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Pancreatic Cancer Risks Studied

Conquest - Fall 2009

Weighing BMI’s impact on pancreatic cancer

In reviewing the weight history of pancreatic cancer patients across their life spans, researchers at M. D. Anderson have determined that high body mass index in early adulthood may play a significant role in someone’s developing the disease at an earlier age.

Donghui Li, Ph.D.

“This is the first study to explore at which ages excess body weight may predispose a person to pancreatic cancer,” says Donghui Li, Ph.D., professor in M. D. Anderson’s Department of Gastrointestinal Medical Oncology and the study’s corresponding author. “With our epidemiological research, we aimed to demonstrate the relationship between BMI and risk of pancreatic cancer across a patient’s life span and determine if there was a time period that specifically predisposes an individual to the disease, as well as the link between BMI and cancer occurrence and overall survival of the disease.”

In the United States, obesity in adults has increased by 60% in the last 20 years and is considered an epidemic by the U.S. Centers for Disease Control and Prevention.

“As we see obesity dangerously on the rise in the country, this study has true public health implications. Like smoking, obesity is a modifiable risk factor,” says James Abbruzzese, M.D., professor and chair of the Department of Gastrointestinal Medical Oncology and senior author on the study. “Our study suggests that weight control at a younger age should be the primary preventive strategy to reduce the risk of pancreatic cancer.”

Reported in the June 24 issue of the Journal of the American Medical Association.

Common drug, new direction for chemoprevention

Taking the most commonly prescribed anti-diabetic drug, metformin, reduces a person’s risk of developing pancreatic cancer by 62%, according to
M. D. Anderson researchers.

“This is the first epidemiologic study of metformin in the cancer population, and it offers an exciting direction for future research for a disease greatly in need of treatment and prevention strategies,” Li says.

An oral medication, metformin is the most commonly prescribed drug for type 2 diabetes. According to Li, more than 35 million prescriptions for the drug are filled annually, and it’s most often given to type 2 diabetic patients who are obese and/or have insulin resistance.

For the study, diabetics were categorized by their use of four common classes of anti-diabetic therapies — insulin or drugs that stimulate insulin production, metformin, thaizolidinediones, and/or other common anti-diabetic therapies — and the duration of use. Diabetics who had taken insulin or insulin stimulators had a 4.99- and 2.52-fold increased risk for pancreatic cancer, respectively, compared with those who had never used it.

Li notes the study has limitations, including the relatively small size of its diabetic population. She hopes the research will be replicated in a larger sample size. Still, the findings present the immediate opportunity to explore metformin as a chemopreventive agent.

Reported in the Aug. 1 issue of Gastroenterology.

© 2015 The University of Texas MD Anderson Cancer Center