胰腺癌与糖尿病因果关系的百年回顾与未来展望OA

The complex relationship between pancreatic cancer and diabetes has been a concern for more than a century.Contemporary epidemiologic data indicate that long-standing type 2 diabetes is associated with an increased risk of pancreatic cancer,whereas new-onset diabetes in middle-aged and older adults may herald an occult malignancy-an association with important implications for prevention and early detection.This review synthesizes historical and contemporary evidence to outline the primary evidence chains linking the two diseases.It examines epidemiological clues,potential pathophysiological mechanisms,and key issues in clinical identification and management.We emphasize time-dependent differences in pancreatic cancer risk across the diabetes trajectory,strategies for identifying and risk-stratifying high-risk individuals,and the potential of biomarkers and multimodal approaches to enable early screening.Taken together,current evidence supports a complex,bidirectional association;routine pancreatic cancer screening among all individuals with diabetes is unwarranted.Instead,stratified screening in well-defined high-risk subgroups is recommended and should be validated prospectively for effectiveness and cost-effectiveness.Looking ahead,multidisciplinary integration and data-driven methods are needed to refine risk prediction and early-diagnostic pathways,with the goal of reducing disease burden and improving outcomes.