Background:
Our team leads the United Kingdom-Early Detection Initiative for pancreatic cancer (UK-EDI), a Cancer Research UK-funded programme aimed at facilitating pancreatic cancer screening in individuals >50 years with new-onset diabetes (NOD). UK-EDI is assembling a NOD cohort, collecting biosamples, clinical and questionnaire data. The programme includes tandem biomarker development and cost-benefit analysis.
Scientific rationale:
At the time of PDAC diagnosis, ~13% of patients have long-standing type 2 diabetes mellitus (diabetes >3 years), consistent with diabetes prevalence in a cancer population. However, ~35% have NOD (diabetes <3 year). NOD is considered an early warning sign of PDAC, and people with NOD constitute the largest high-risk group for pancreatic cancer.
Diabetes secondary to pancreatic disease (including PDAC-related diabetes) is called type 3c diabetes or pancreatogenic diabetes. Type 3c diabetes frequently precedes the diagnosis of PDAC, providing a window of opportunity for early cancer detection. However, it is often misdiagnosed as type 2 diabetes.
Research questions:
Could a routine test that distinguishes type 3c from type 2 diabetes facilitate early detection of PDAC? Our cost-effectiveness analysis revealed that a test that distinguishes type 3c from type 2 diabetes, followed by a cancer-specific test to distinguish pancreatic cancer-related diabetes from other forms of type 3c diabetes approaches cost-effectiveness. We have an existing pipeline of type 3c and cancer-specific biomarkers.
Objectives:
* To develop a predictive model integrating clinical features, symptom profiles, and proteomic biomarkers to distinguish T3cDM from T2DM.
* To identify and validate early detection biomarkers for PDAC using pre-diagnostic UKB with UKB-PPP data annotation.
* To improve risk stratification in individuals with NOD through analysis of genetic, lifestyle, and health records.