Pancreatic Cancer Can Be Misdiagnosed in Diabetics

CA 19-9 is a tumor-associated antigen that is elevated in pancreatic cancers, cancers of the upper gastrointestinal tract, ovarian cancer, hepatocellular cancer, colorectal cancer, inflammatory conditions of the hepatobiliary system, and in thyroid diseases.

Diabetes is increasing all over the world along with the increase of obesity and associated diseases and is a well-known risk factor for pancreatic cancer. The incidence of pancreatic cancer is also increasing and has one of the lowest survival rates of all cancers.

Although CA (cancer antigen) 19-9 is used in the diagnosis of pancreatic cancer it is also a marker of pancreatic tissue damage that might be caused by diabetes. The association between diabetes, pancreatic cancer, and elevated levels of CA 19-9 was investigated in a study that was published in the October 28, 2007, issue of the World Journal of Gastroenterology.

A team of investigators led by Assoc. Prof. Oya Uygur-Bayramicli, department of gastroenterology, Kartal State Hospital (Istanbul, Turkey) examined 76 type II diabetics and compared them with control subjects of the same age and gender. CA 19-9 levels were statistically significantly higher in the diabetic group but there was not any case of pancreatic cancer in that group, which was confirmed by abdominal computed tomography (CT).

The scientists concluded that diabetes could be the cause of chronic pancreatitis, which can cause the elevation of CA 19-9 in the absence of pancreatic cancer. They recommended using higher cut-off values of CA 19-9 in diabetic patients to differentiate benign and malignant pancreatic disease. Furthermore, subtle elevations of CA 19-9 in diabetics should be considered an indication of exocrine pancreatic dysfunction.


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Kartal State Hospital