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Hepatobiliary Pancreat Dis Int. 2018 Jun;17(3):263-268. doi: 10.1016/j.hbpd.2018.04.001. Epub 2018 Apr 20.

Usefulness of CA 19-9 for pancreatic cancer screening in patients with new-onset diabetes.

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Department of Internal Medicine, Korea University College of Medicine, Seoul 08308, Korea.
Department of Internal Medicine, Korea University College of Medicine, Seoul 08308, Korea. Electronic address:
Department of Biostatistics, Korea University Medical Center, Seoul 08308, Korea.



Generally, carbohydrate antigen 19-9 (CA 19-9) is not useful for screening pancreatic cancer in the asymptomatic general population. This study aimed to evaluate the utility of CA 19-9 level as a screening indicator of pancreatic cancer in asymptomatic patients with new-onset diabetes.


We retrospectively reviewed the medical records of patients who visited our health promotion center for health check-ups without cancer related symptoms from January 2005 to January 2014, and were newly diagnosed with diabetes mellitus (DM) within 2 years before their visit.


Of the 5111 asymptomatic patients with new-onset DM (<2 years) selected for analyses, 87 (1.7%) eventually developed pancreatic cancer after the health check-up. In the subgroup of 322 patients with high total bilirubin levels (>1.7 mg/dL) at the screening time, 42 (73.7%) of 57 patients with high CA 19-9 levels (>37 IU/mL) had been diagnosed as pancreatic cancer during follow-up period and 12 (4.5%) of 265 patients with normal CA 19-9 levels had finally developed pancreatic cancer (OR = 16.3). In the subgroup of 4789 patients with normal bilirubin levels, pancreatic cancer had been detected in 20 (3.8%) of 522 patients with high CA 19-9 level, while only 13 (0.3%) in 4267 patients with normal CA 19-9 levels (OR = 12.6), respectively.


CA 19-9 levels after a diagnosis of new-onset DM could be a useful biomarker of pancreatic cancer, especially in patients with high serum bilirubin.


Bilirubin; Carbohydrate antigen 19–9; Diabetes mellitus; Early detection of cancer; Pancreatic neoplasms

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