{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:30:05Z","timestamp":1787841005252,"version":"build-2784847793"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,8,1]],"date-time":"2012-08-01T00:00:00Z","timestamp":1343779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2013,1,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Recent evidence has identified pre\u2010existing type 2 diabetes mellitus (T2DM) as a risk factor for the development of PAC, but relatively little is known about its effects on survival. Our aim was to determine the effect of varying durations of pre\u2010existing T2DM on survival in patients with PAC.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>We conducted a retrospective cohort study using The Health Improvement Network (THIN), a primary care electronic medical record database from the UK (2003\u20102010). The study cohort included all subjects with a diagnostic code for PAC. Subjects with a diagnostic code for T2DM before their PAC diagnosis were classified as exposed; otherwise, subjects were classified as unexposed. The primary outcome was overall survival. The analysis was performed using univariate and multivariable Cox proportional\u2010hazards models. Additional analysis was performed to assess the effect of increasing duration of pre\u2010existing T2DM [i.e., &lt;90 days, 90 days to &lt;1 year, 1 to &lt;3 years, 3 to 5 years, &gt;5 years] on survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>The study included 3,147 patients with PAC, with 745 patients having pre\u2010existing T2DM and 2,402 patients without pre\u2010existing T2DM. In the primary multivariate analysis, there was no difference in survival between those exposed and those unexposed to pre\u2010existing T2DM (HR 1.02 [0.93, 1.12], <jats:italic>p<\/jats:italic> = 0.620). In the secondary analysis, only those patients with T2DM &gt; 5 years duration had a significantly increased mortality (HR 1.16 [1.00, 1.33], <jats:italic>p<\/jats:italic> &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Long\u2010term pre\u2010existing T2DM is associated with increased mortality in patients diagnosed with PAC. 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