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September 27, 2000

Relationship Between Glucose Metabolism and Pancreatic Cancer

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(12):1512. doi:10.1001/jama.284.12.1512

To the Editor: Dr Gapstur and colleagues1 found a significant relationship in men, but not women, for an elevated postload plasma glucose determination and the subsequent risk of pancreatic cancer. The authors controlled for smoking, which might have explained the observed sex-specific risk difference, but not for alcohol intake. In a similar follow-up study of subjects with impaired glucose tolerance, deaths due to alcohol and cirrhosis were 7 times higher in persons with an abnormal glucose tolerance than in normoglycemic persons.2 Frequent alcohol use occurs more often in men than women, is known to damage the pancreas, and is the most common cause of chronic pancreatitis—a suspected risk factor for pancreatic cancer. Could confounding from high alcohol intake explain why only men with an abnormal postload plasma glucose level had an increased risk of pancreatic cancer?

Gapstur  SMGann  PHLowe  WKiang  LColangelo  LDyer  A Abnormal glucose metabolism and pancreatic cancer mortality.  JAMA. 2000;283:2552-2558.Google Scholar
Balkau  BEschwege  EDucimetiere  PRichard  JLWarnet  JM The high risk of death by alcohol related diseases in subjects diagnosed as diabetic and impaired glucose tolerant: the Paris Prospective Study after 15 years of follow-up.  J Clin Epidemiol. 1991;44:465-474.Google Scholar