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

Jung Wan Choe, Hyo Jung Kim, Jae Seon Kim, Jaehyung Cha, Moon Kyung Joo, Beomjae Lee, Jong Jae Park, Young-Tae Bak

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: 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. Methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish
JournalHepatobiliary and Pancreatic Diseases International
Publication statusAccepted/In press - 2018 Jan 1


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

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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