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Спутники
РН
SpaceX
Роскосмос
NASA
СпутникиРНSpaceXРоскосмосNASAIn Reply We thank Wu for their interest and insightful comments on our work. We agree that diabetes and pancreatitis may represent both risk factors and clinical states that could reflect preclinical pancreatic disease. Previous studies have suggested that pancreatic cancer–associated new-onset diabetes frequently occurs within approximately 2 to 3 years before pancreatic cancer diagnosis, with many cases occurring within the first 2 years. Similarly, pancreatitis occurring shortly before pancreatic cancer diagnosis, especially within 1 to 2 years, may reflect tumor-related processes rather than an independent risk factor. Therefore, we excluded participants with diabetes or pancreatitis diagnosed within 2 years before pancreatic cancer diagnosis to reduce the potential influence of reverse causation. We acknowledge that applying a longer lag period, such as 5 years, could further reduce the possibility that diabetes or pancreatitis represent manifestations of occult pancreatic cancer. However, a longer lag period would substantially reduce the number of pancreatic cancer events, thereby limiting statistical power, particularly given the relatively low incidence of pancreatic cancer and the small number of participants with pancreatitis. Moreover, a longer lag period may also exclude individuals whose diabetes or pancreatitis reflects a true underlying risk factor rather than preclinical cancer, potentially leading to an underestimation of their association with pancreatic cancer risk.