INS and familial pancreatic carcinoma: Using MR, prior research has shown a causal association between pancreatic cancer, cholelithiasis, Crohn disease, type 2 diabetes mellitus, and fasting insulin levels.[6–8] All of these MR investigations examine the causal association between exposure and pancreatic cancer, but their breadth of interest is limited since they are predicated on the theory of the disease’s origin.