{"entity":{"id":"paper-sharma-endpac-model-new-onset-diabetes-gastroenterology-2018","kind":"paper","name":"Model to Determine Risk of Pancreatic Cancer in Patients With New-Onset Diabetes","aka":[],"tldr":"The 2018 Mayo Clinic score, called ENDPAC, that uses weight change, blood sugar change and age at diabetes onset to pick out the new diabetics whose risk of pancreatic cancer is high enough to scan.","summary":"Sharma, Chari and colleagues built the Enriching New-Onset Diabetes for Pancreatic Cancer (ENDPAC) model from four cohorts (1,561 patients) with glycaemically defined new-onset diabetes in the Rochester Epidemiology Project, 2000 to 2015, weighting three factors, change in weight, change in blood glucose and age at onset, and validated it in an independent cohort of 1,096. In the discovery cohort (64 pancreatic cancer, 192 type 2 diabetes) the area under the curve was 0.87 and a score of 3 or more had 80 percent sensitivity and specificity; in validation a score of 3 or more identified 7 of 9 cancers (78 percent) at 85 percent specificity, with a cancer prevalence of 3.6 percent among high scorers, 4.4-fold that of new-onset diabetes overall. A score of 0 or below (49 percent of patients) meant extremely low risk. A high score identified 75 percent of cases more than six months before diagnosis.","asOf":"2026-09-24","links":[{"label":"Gastroenterology 2018","url":"https://doi.org/10.1053/j.gastro.2018.05.023"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/29775599/"},{"label":"ClinicalTrials.gov NCT04164602","url":"https://clinicaltrials.gov/study/NCT04164602"}],"tags":["pancreatic-evidence"],"related":["paper-chari-pancreatic-cancer-following-diabetes-gastroenterology-2005","paper-fahrmann-ca19-9-lead-time-gastroenterology-2021","idea-mced-new-onset-diabetes"],"cancers":["pancreatic"],"sections":[],"technologies":["ct","mri","pancreatic-surveillance","mced"],"targets":[],"drugs":[],"companies":[],"institutions":["mayo-clinic"],"pathways":[],"terms":["ppv"],"trials":[],"people":[],"bottlenecks":["b-early-detection"],"keyPapers":[],"journals":["gastroenterology"],"dependsOn":[],"notes":[],"journal":"Gastroenterology","year":2018,"doi":"10.1053/j.gastro.2018.05.023","pmid":"29775599","authors":"Sharma A, Kandlakunta H, Nagpal SJS, et al.","paperType":"observational","findings":["Three inputs: weight change, glucose change, age at onset; area under the curve 0.87.","Score 3 or more: 78 percent sensitivity, 85 percent specificity in validation; cancer prevalence 3.6 percent.","Score 0 or below in 49 percent of patients, extremely low risk.","75 percent of cases identified more than six months before diagnosis."],"whatItMeans":"A scoring tool that needs no new test and can run in primary care records; it turns the 1 percent of Chari's cohort into a 3.6 percent group in whom imaging or a blood test becomes defensible.","caveats":["Retrospective; the authors call for an independent prospective study, which the US NOD cohort and the Hungarian NODES cohort (NCT04164602) are attempting.","Nine cancers in the validation cohort."],"participants":2657},"route":"/key-papers/paper-sharma-endpac-model-new-onset-diabetes-gastroenterology-2018/","neighbours":{"paper":[{"id":"paper-fahrmann-ca19-9-lead-time-gastroenterology-2021","kind":"paper","name":"Lead-Time Trajectory of CA19-9 as an Anchor Marker for Pancreatic Cancer Early Detection","route":"/key-papers/paper-fahrmann-ca19-9-lead-time-gastroenterology-2021/"},{"id":"paper-chari-pancreatic-cancer-following-diabetes-gastroenterology-2005","kind":"paper","name":"Probability of pancreatic cancer following diabetes: a population-based study","route":"/key-papers/paper-chari-pancreatic-cancer-following-diabetes-gastroenterology-2005/"}],"idea":[{"id":"idea-mced-new-onset-diabetes","kind":"idea","name":"Blood-based pancreatic cancer detection in new-onset diabetes","route":"/ideas/idea-mced-new-onset-diabetes/"},{"id":"idea-pdac-new-onset-diabetes-risk-score-pathway","kind":"idea","name":"Run the ENDPAC score on every new diabetes diagnosis after 50 and scan the high scorers","route":"/ideas/idea-pdac-new-onset-diabetes-risk-score-pathway/"}],"cancer":[{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"technology":[{"id":"ct","kind":"technology","name":"CT (computed tomography)","route":"/technologies/ct/"},{"id":"pancreatic-surveillance","kind":"technology","name":"High-risk pancreatic surveillance (CAPS / PRECEDE)","route":"/technologies/pancreatic-surveillance/"},{"id":"mri","kind":"technology","name":"MRI","route":"/technologies/mri/"},{"id":"mced","kind":"technology","name":"Multi-cancer early detection (MCED)","route":"/technologies/mced/"}],"institution":[{"id":"mayo-clinic","kind":"institution","name":"Mayo Clinic","route":"/institutions/mayo-clinic/"}],"term":[{"id":"ppv","kind":"term","name":"Positive predictive value (PPV)","route":"/terms/ppv/"}],"bottleneck":[{"id":"b-early-detection","kind":"bottleneck","name":"The hardest cancers are found late","route":"/bottlenecks/b-early-detection/"}],"journal":[{"id":"gastroenterology","kind":"journal","name":"Gastroenterology","route":"/journals/gastroenterology/"}],"roadmap":[{"id":"pancreatic-roadmap","kind":"roadmap","name":"Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question","route":"/roadmaps/pancreatic-roadmap/"}]}}