Towards early detection of pancreatic cancer: The current status of cohort studies by the Diabetes-Pancreatic Ductal AdenoCarcinoma Working Group.

The Diabetes-Pancreatic Ductal Adenocarcinoma Working Group (DM-PDAC WG) was formed within the Consortium for Study of Chronic Pancreatitis Diabetes and Pancreatic Cancer (CPDPC) to study the link between new-onset diabetes and pancreatic cancer. Its goals were to i) estimate the risk of PDAC in a prospectively assembled cohort of individuals with NOD identified at its glycemic onset (GNOD), ii) Establish a biobank of clinically annotated bio-specimens from GNOD subjects with pre-symptomatic PDAC and control new-onset type 2 DM, iii) Conduct Phase 3 validation studies of promising biomarkers for identification of occult PDAC in GNOD; iv) Provide a platform for development of a future interventional screening protocol for early detection of PDAC in NOD patients that incorporates imaging studies and clinical algorithms. The study identified >20,000 subjects with GNOD and assembled a biobank of serial blood samples in 2270 GNOD subjects. The risk of PDAC in GNOD and the distribution of lead time from GNOD to PDAC clinical diagnosis have been definitively defined in a cohort of 18,838 GNOD subjects identified during the course of the study. Ongoing biomarker and metabolomics studies will not only provide data on performance of tested biomarkers, but also an unprecedented repository of data on a large number of type 2 DM subjects. There are also ongoing studies on the "science of NOD" to understand its pathogenesis. Overall, the DM-PDAC Working Group has been successful in its mission to further our understanding of the link between diabetes pancreatic cancer.