Validation of the ENDPAC model: Identifying new-onset diabetics at risk of pancreatic cancer
| Autor: | Rudi Fnu Safarudin, Salman Khan, Justin Kupec |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Oncology
Male medicine.medical_specialty Optimal cutoff Endocrinology Diabetes and Metabolism Models Biological Risk Assessment Sensitivity and Specificity Article New onset Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Weight loss Risk Factors Internal medicine Diabetes mellitus Pancreatic cancer Clinical Decision Rules medicine Diabetes Mellitus Humans Early Detection of Cancer Aged Retrospective Studies Aged 80 and over Lost Weight Hepatology business.industry Gastroenterology Middle Aged medicine.disease Gained weight Pancreatic Neoplasms 030220 oncology & carcinogenesis Case-Control Studies Cohort 030211 gastroenterology & hepatology Female medicine.symptom business |
| Zdroj: | Pancreatology |
| ISSN: | 1424-3911 |
| Popis: | BACKGROUND: Patients with new-onset diabetes are known to be at a higher risk of developing pancreatic cancer. The Enriching New-Onset Diabetes for Pancreatic Cancer (ENDPAC) model was recently developed to identify new-onset diabetics with this higher risk. Further validation is needed before the ENDPAC model is implemented as part of a screening program to identify pancreatic cancer. METHODS: A retrospective case-control study was performed; a cohort of patients with new-onset diabetes was identified using hemoglobin A1c. Patients were scored by the ENDPAC model and then divided based on whether pancreatic cancer was diagnosed after the diagnosis of diabetes. The performance of the model was assessed globally and at different cutoffs. RESULTS: There were 6254 controls and 48 cases of pancreatic cancer. Bivariate analysis showed that patients with pancreatic cancer lost weight before diagnosis while controls gained weight (−0.93 kg/m2 vs. 0.45 kg/m2, p < 0.00*). Cases had a more significant increase in their HbA1C from one year before (1.3% vs. 0.82%, p = 0.02). Smoking and pancreatitis rates were higher in cases compared to controls (p < 0.00*). The area under the curve (AUC) of the ENDPAC model was 0.72. A score >1 was the optimal cutoff. At this cutoff, the sensitivity was 56%, specificity was 75%, and pancreatic cancer prevalence increased from 0.78% at baseline to 1.7%. CONCLUSION: The ENDPAC model was validated in an independent cohort of patients with new-onset diabetes. |
| Databáze: | OpenAIRE |
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