Evaluating diabetes as a risk pathway towards early diagnosis and prognostication of pancreatic ductal adenocarcinoma (PDAC) using the UK QResearch database
What is the aim of the study and why is it important?
In this study, we will evaluate:
(1) association between type-2 diabetes and related illnesses with pancreatic cancer,
(2) quantify referrals for pancreatic cancer scans amongst patients diagnosed with type-2 diabetes in primary care in line with NICE guidance, and
(3) identify potential markers to predict pancreatic cancer among type-2 diabetes patients diagnosed in primary care.
Despite improvements in treatment and care, pancreatic cancer remains to be a very deadly disease. This is mainly due to patients presenting at late stages of disease as it mostly shows no or vague symptoms in early stages. About 25-50% of patients who develop pancreatic cancer have diabetes. However, currently, pancreatic cancer has only been found in approximately 1% of new-onset T2DM over 3 years, and hence, there remains an important need for GPs to better identify at-risk patients. Patients with pancreatic cancer who are diagnosed at an earlier stage have more treatment options and may even be able to undergo surgery and ultimately survive longer.
How is the research being done?
We will use primary care information from QResearch – a database containing anonymised GP records of patients in England, taken over a period of over 30 years. This will be linked to hospital records, cancer registry and death records to search for individual new-onset diabetes patient characteristics (e.g. age, gender, lifestyle) that are associated with a later diagnosis of pancreatic cancer. These linkages will be used to generate estimates using standard statistical procedures to better understand how pancreatic cancer can be diagnosed earlier among type-2 diabetes patients presenting in GP clinics.
Professor Julia Hippisley-Cox and Dr Pui San Tan
Lead Applicant Organisation Name
Location of research
University of Oxford
Date on which research approved
Project reference ID
Generic ethics approval reference
Are all data accessed are in anonymised form?
Brief summary of the dataset to be released (including any sensitive data)
We will use primary care information from QResearch – linked to Hospital Episode Statistics (HES), the Cancer Registry and the Civil Registry.
Implications and Impact
This study will help better understand the association between diabetes and pancreatic cancer and identify potential opportunities for earlier detection of pancreatic cancer by GPs.
Public Benefit Statement
Professor Julia Hippisley-Cox, University of Oxford
Dr Carol Coupland, University of Nottingham
Dr Pui Tan, University of Oxford
Mr Weiqi Liao, University of Oxford
Dr Ashley Clift, University of Oxford
Dr Rachael Bashford-Rogers, University of Oxford
Dr Shivan Sivakumar, University of Oxford
Dr Cesar Garriga, University of Oxford
Temporality of body mass index, blood tests, comorbidities and medication use as early markers for pancreatic ductal adenocarcinoma (PDAC): a nested case–control study
Authors: Pui San Tan , Cesar Garriga, Ashley Clift, Weiqi Liao, Martina Patone, Carol Coupland, Rachael Bashford-Rogers, Shivan Sivakumar, Julia Hippisley-Cox
- Early detection innovation award for Oxford researchers
- Time-varying nature of clinical risk factors for pancreatic cancer may aid earlier diagnosis
Trusted Research Environment (TRE)