UK-EDI: Early Detection Initiative Study

Oldfield L, Stott M, Hanson R, Jackson RJ, Reynolds W, Chandran-Gorner V, Van Der Meer R, Alison L, Tejeiro R, Purewal T, Ghaneh P, Palmer D, Greenhalf W, Halloran C, Costello E. United Kingdom Early Detection Initiative (UK-EDI): protocol for establishing a national multicentre cohort of individuals with new-onset diabetes for early detection of pancreatic cancer. BMJ Open. 2022 Oct 10;12(10):e068010. doi: 10.1136 /bmjopen-2022-068010. PMID: 36216424; PMCID: PMC9557307.

Lay Summary

This paper outlines the protocol for the UK-EDI study.

🧠 What’s the big idea?

Pancreatic cancer is one of the deadliest cancers because it’s usually found late. But scientists have noticed that some people develop diabetes shortly before being diagnosed with pancreatic cancer. This study explores whether new-onset diabetes (NOD) could be an early warning sign.

🎯 What is UK-EDI trying to do?

The UK-EDI study is setting up a national research project to follow 2,500 people aged 50 and over who have recently been diagnosed with diabetes (within the last 6 months). The goal is to:

• Track their health over time
• Collect blood and biological samples.
• Look for biomarkers or patterns that might signal early pancreatic cancer

🔬 How will it work?

• Participants are followed for 3 years, with check-ins every 6 months.
• Researchers gather clinical data, lifestyle information, and biological samples.
• They’ll use this information to see how early signs of pancreatic cancer can be spotted this high-risk group.

💡 Why is this important?

• Help doctors identify pancreatic cancer earlier
• Lead to better screening tools for people with new-onset diabetes
• Potentially save lives by catching cancer before it spreads

Biomarkers, Omics and AI Review

Murray K, Oldfield L, Stefanova I, Gentiluomo M, Aretini P, O'Sullivan R, Greenhalf W, Paiella S, Aoki MN, Pastore A, Birch-Ford J, Rao BH, Uysal-Onganer P, Walsh CM, Hanna GB, Narang J, Sharma P, Campa D, Rizzato C, Turtoi A, Sever EA, Felici A, Sucularli C, Peduzzi G, Öz E, Sezerman OU, Van der Meer R, Thompson N, Costello E Biomarkers, omics and artificial intelligence for early detection of pancreatic cancer. Semin Cancer Biol. 2025 Jun;111:76-88. doi: 10.1016 /j.semcancer.2025.02.009. PMID: 39986585.

Lay Summary

This article, led by the Costello team and comprising members of the international consortium TRANSPAN reviews progress in the early detection of pancreatic cancer.

🧬 What problem is being addressed?

Pancreatic cancer, especially the most common type called pancreatic ductal adenocarcinoma (PDAC), is often diagnosed too late—when treatment options are limited and survival rates are low. Unlike other cancers, there’s no routine screening for the general population.

🔍 What’s the goal of the review?

The researchers aim to explore how we can detect pancreatic cancer earlier, especially in people who are at higher risk. They focus on using:

• Biomarkers (biological signs in blood or tissue)
• Omics technologies (like genomics and proteomics)
• Artificial intelligence (AI) to analyze large data sets, including health records and even social media.

🧪 What are biomarkers and what does ‘omics’ refer to?

• Biomarkers are measurable indicators of a disease—like proteins or genes that change when cancer is present.
• Omics refers to large-scale studies of biological molecules (like DNA, RNA, or proteins) to understand disease patterns.

🤖 How does AI help?

• Identify people at risk earlier
• Predict who might develop cancer
• Improve the accuracy of biomarker tests

💰 Can it be made cost-effective?

The paper also looks at cost-effectiveness—whether using these advanced tools is financially practical for healthcare systems. The authors suggest that targeted screening in high-risk groups could be a smart investment.

🧭 Why does this matter?

Early detection could save lives by catching pancreatic cancer before it spreads. This research shows that combining biology with technology might be the key to making that possible.

Adiponectin and IL-1Ra as Biomarkers

Oldfield L, Evans A, Rao RG, Jenkinson C, Purewal T, Psarelli EE, Menon U, Timms JF, Pereira SP, Ghaneh P, Greenhalf W, Halloran C, Costello E. Blood levels of adiponectin and IL-1Ra distinguish type 3c from type 2 diabetes: Implications for earlier pancreatic cancer detection in new-onset diabetes. EBioMedicine. 2022 doi: 10.1016/j.ebiom.2021.103802. PMID: 34990893.

Lay Summary

One in three people with pancreatic cancer develop diabetes before their cancer is diagnosed. Identifying diabetes that occurs due to pancreatic cancer could help us detect and diagnose this difficult to treat cancer earlier.

Pancreatic cancer-related diabetes is known as type 3c diabetes, and it occurs because of a disease in the pancreas. Other conditions, such as chronic pancreatitis, can also cause type 3c diabetes. There are no tests for type 3c diabetes, and people are frequently misdiagnosed with the more common type 2 form of the disease. Importantly, this means than an opportunity to detect pancreatic cancer earlier is missed.

We have looked in the blood of people with diagnosed pancreatic cancer, chronic pancreatitis and diabetes to find molecules (called proteins) that can help us distinguish type 3c from type 2 diabetes. In this manuscript we show that the combined measurement of the proteins adiponectin and interleukin-1 receptor antagonist (IL-1Ra) allows the distinction of type 3c diabetes from type 2 diabetes. We also looked at IL-1Ra in blood samples taken from people up to 1 year before their diagnosis of pancreatic cancer and show that a distinction between the two forms of diabetes is maintained. This highlights the potential of IL-1 Ra to act in support of earlier pancreatic cancer detection.

Adiponectin and IL-1Ra are now being further developed in the UK-EDI study.

Prevalence of New-Onset Diabetes in Patients Undergoing Pancreatic Surgery

Stott, M; Stefanova, I; Oldfield, L; Evans, A; Birch-Ford, J; Rao, R; Greenhalf, W; Halloran, C; Costello, E. Prevalence of New-Onset Diabetes in Patients Undergoing Pancreatic Surgery and the Association of Glucose Dysregulation With Complications in Pancreatic Cancer Annals of Surgery Open 6(2):p e584, June 2025. | DOI: 10.1097/AS9.0000000000000584.

Lay Summary

The UK-EDI team wanted to find out how common it is for people to have new-onset diabetes (NOD)—meaning diabetes that was diagnosed within three years of surgery before—when they undergo pancreatic surgery, especially for pancreatic cancer (specifically pancreatic ductal adenocarcinoma, or PDAC).

The team looked back at the medical records of 483 people who had pancreatic surgery between 2016 and 2020. For those with pancreatic cancer, they examined how blood sugar levels were linked to tumor size, how advanced the cancer was, how aggressive it looked, and how patients recovered after surgery.

They found that about 35% of patients with pancreatic cancer (PDAC) had new-onset diabetes at the time of surgery. This was much higher than in patients being operated from other pancreatic diseases. In over one-third of PDAC patients with new-onset diabetes, the diabetes was only discovered during pre-surgery testing—the patients did not know they had diabetes.

People with diabetes had a higher chance of delayed stomach emptying after surgery. Interestingly, they had a lower chance of a common complication called a pancreatic fistula (a leak from the surgical site).

This work matters because: New-onset diabetes could be an early warning sign of pancreatic cancer. Testing blood sugar levels before surgery might help catch undiagnosed diabetes. Knowing a patient’s blood sugar status could help doctors predict and manage surgical risks better.