Pancreatic cancer could be identified in patients up to three years earlier than current diagnoses, new research suggests. Weight loss and increasing blood glucose levels are early indicators of pancreatic cancer and could lead to timelier diagnosis, helping to improve survival rates.

In the study, researchers from the University of Surrey, in partnership with Pancreatic Cancer Action and the University of Oxford, investigated signs of cancer, including weight loss, hyperglycemia, and diabetes and demonstrated the timelines for when they develop in relation to cancer. The pancreas is a vital organ with two key functions, to produce insulin and digestive enzymes. Cancer can affect one or both functions leading to the aforementioned symptoms.

Currently, almost 90% of people with pancreatic cancer are diagnosed too late for curative treatment.  

“Due to the difficulty in detecting pancreatic cancer, survival rates are extremely poor compared to other cancers, with less than 10 per cent of people surviving five years or more after diagnosis,” says lead author Agnieszka Lemanska, PhD, MSc, lecturer in data science at the University of Surrey. “Weight loss and increased blood glucose are recognized symptoms of pancreatic cancer. However, the extent of these symptoms and when they manifest have been unknown. Knowing when they develop will help clinicians to diagnose this deadly cancer, meaning treatment can begin earlier.”

Ali Stunt, founder and CEO of Pancreatic Cancer Action, and a cancer survivor herself, says: “I was lucky to be diagnosed in time for surgery and ‘beat the odds’, but sadly this is not the case for everyone. Symptoms for pancreatic cancer are ambiguous and difficult for clinicians to diagnose; it was originally thought I had gallstones.”

Using the Oxford-Royal College of General Practitioners Clinical Informatics Digital Hub (ORCHID), researchers analyzed the data of 8,777 patients diagnosed with pancreatic cancer and compared it to a control group of 34,979.

Researchers found that dramatic weight loss in people with pancreatic cancer could be detected two years before they received an official diagnosis.  At the time of diagnosis, body max index (BMI) was lower in those with pancreatic cancer by three units. The elevation in glycated hemoglobin (HbA1c) was detectable even earlier, from three years before the diagnosis.

Further statistical analysis revealed that weight loss in people with diabetes was associated with a higher risk of pancreatic cancer than in those without the condition. It was also found that hyperglycemia in people without diabetes was associated with a higher risk of cancer than in people with diabetes.

“Our research suggests that a dramatic and unexplained weight loss, mainly in people with, but also in those without diabetes, as well as an unexplained hyperglycemia, should be treated with high levels of suspicion,” says Professor Simon de Lusignan of the University of Oxford.

Findings from the study have led researchers to call for clinicians to conduct BMI and HbA1c assessments more regularly for their patients with and without diabetes. This would help identify those with pancreatic cancer.  

“BMI and HbA1c are simple measures routinely collected in clinical practice. However, the challenge for research is the irregular testing of BMI and HbA1c and missing data,” Lusignan added. “For example, we see that BMI and HbA1c were more scarcely recorded for people without a diagnosis of diabetes than for people with diabetes. Data-driven approaches could be important tools that help clinicians identify patients at risk. However, this relies on the quality and completeness of data. Regular HbA1c and BMI measurements in primary care would not only improve diabetes and pancreatic cancer diagnoses but would also improve the quality of routine data for research.”

This study was published in PLOS ONE.