{"entity":{"id":"idea-prev-new-onset-diabetes-pancreas-pathway","kind":"idea","name":"New diabetes after 50 plus weight loss triggers a pancreatic cancer check","aka":[],"tldr":"About one in a hundred people who develop diabetes after 50, more if they are losing weight, have pancreatic cancer. A simple score could send them for a scan or blood test.","summary":"New diabetes after 50, especially with weight loss, can be an early sign of pancreatic cancer, so this idea builds an automated EHR alert around the Mayo Clinic ENDPAC score, which uses age, weight change and glucose trajectory, and sends high-scoring patients for CT or MRI or a CA19-9 or methylation blood test. New-onset diabetes is a paraneoplastic effect of early pancreatic cancer, the window is one to three years, and the population can be enumerated in primary care. The aim is to raise the share of pancreatic cancers among new diabetics diagnosed at a resectable stage. A cluster-randomised trial across primary care networks would measure stage at diagnosis, resection rate and scans per cancer. At early-clinical maturity, it addresses the bottleneck The hardest cancers are found late.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (The hardest cancers are found late): Crosby et al., Early detection of cancer (Science 2022)","url":"https://doi.org/10.1126/science.aay9040"}],"tags":[],"related":[],"cancers":["pancreatic"],"sections":["early-detection"],"technologies":["ct","mri","liquid-biopsy"],"targets":[],"drugs":[],"companies":[],"institutions":["mayo-clinic"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-early-detection"],"keyPapers":["paper-crosby-science"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"ENDPAC-triggered work-up raises the proportion of pancreatic cancers diagnosed at resectable stage among new-onset diabetics from about 15% to at least 35%.","rationale":"New diabetes is a paraneoplastic effect of early pancreatic cancer; the window is one to three years and the population is enumerable in primary care.","test":"Cluster-randomised trial across primary care networks; endpoints stage at diagnosis, resection rate, and scans per cancer.","maturity":"early-clinical","actor":"clinic","cost":"medium","horizonYears":4},"route":"/ideas/idea-prev-new-onset-diabetes-pancreas-pathway/","neighbours":{"cancer":[{"id":"ipmn-cystic-precursors","kind":"cancer","name":"Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors","route":"/cancers/ipmn-cystic-precursors/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"}],"technology":[{"id":"ct","kind":"technology","name":"CT (computed tomography)","route":"/technologies/ct/"},{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"mri","kind":"technology","name":"MRI","route":"/technologies/mri/"}],"institution":[{"id":"mayo-clinic","kind":"institution","name":"Mayo Clinic","route":"/institutions/mayo-clinic/"}],"bottleneck":[{"id":"b-early-detection","kind":"bottleneck","name":"The hardest cancers are found late","route":"/bottlenecks/b-early-detection/"}],"paper":[{"id":"paper-crosby-science","kind":"paper","name":"Early detection of cancer","route":"/key-papers/paper-crosby-science/"}],"term":[{"id":"new-onset-diabetes-pancreatic-cancer","kind":"term","name":"New-onset diabetes as a signal of pancreatic cancer (and the ENDPAC score)","route":"/terms/new-onset-diabetes-pancreatic-cancer/"}]}}