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Glucose monitor data as an early pancreatic cancer signal

Millions now wear continuous glucose monitors. A sudden, unexplained worsening of glucose control in a middle-aged wearer could be flagged as a possible early sign of pancreatic cancer.

Pancreatic cancer causes new or worsening diabetes one to three years before diagnosis. Continuous glucose monitor streams give a far finer signal of glycaemic drift than sporadic HbA1c. Propose a retrospective study linking CGM data to pancreatic cancer outcomes to define a drift signature, then a prospective alert routing flagged users to ENDPAC-style work-up.

Hypothesis
A CGM-derived glycaemic drift signature identifies incident pancreatic cancer with a positive predictive value of at least 2% in wearers over 50, enough to justify imaging.
Rationale
The biology is established; the sensor data is new and continuous; the population is large and, on many platforms, already consented for research use.
What would test it
Start with retrospective linkage in a large CGM database with cancer registry outcomes (small cost); then run a prospective alert pilot.
Maturity
speculative
Who has to act
data
Cost to try
Small (under $1M)
Years to first evidence
4
Bottlenecks it attacks
  • Most lethal cancers are found late · Screening exists for only a few cancers. Pancreatic, ovarian, liver, oesophageal and most lung cancers are found when cure is unlikely.

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