Pancreatic cancer screening yields moderate benefit, ‘no harms’ for high-risk patients
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CHARLOTTE, N.C. — Pancreatic cancer screenings in high-risk individuals identified high-risk lesions in nearly 1% of patients and intermediate-risk pathology in more than 30%, according to data presented at the ACG Annual Scientific Meeting.
“Although pancreatic cancer screening has been increasingly studied in the last few years, there is a large variation in the yield, outcomes and harms of this screening in the literature,” Andy Silva-Santisteban, MD, a research fellow at the Center for Advanced Endoscopy at Beth Israel Deaconess Medical Center, told Healio. “To overcome these limitations, we proposed a large, multicenter prospective cohort study conducted at five academic medical institutions across the United States.”
Silva-Santisteban and colleagues prospectively enrolled 252 high-risk patients (mean age, 59.9 years; 69% women) who underwent endoscopic ultrasound (n = 208) or magnetic resonance cholangiopancreatography (n = 44) for pancreatic cancer screening. Genetic susceptibility was the leading indication for screening.
According to results, low-risk pancreatic pathology was detected in 23.4% of patients, while intermediate-risk lesions were found in 31.7% of patients. High-risk lesions — which were identified as adenocarcinoma — were found in 0.8% of patients, which Silva-Santisteban noted was “at the lower end of the range that has been reported in the literature.”
In addition, new-onset prediabetes was noted in 18.2% of screened patients and new-onset diabetes in 1.7%.
The researchers reported no adverse events during screening, and that no patient underwent low-yield pancreatic cancer surgery.
“Patients should be carefully counseled regarding benefits and harms from pancreatic cancer screening,” Silva-Santisteban said. “When feasible, such screening should be performed within the confines of a research study, so data to inform future decisions may be collected.”
He added, “Other high-quality, large multicenter studies should be undertaken using standardized protocols to evaluate the yield of pancreatic cancer in at-risk patients, adverse effects of [endoscopic ultrasound] and MRI as methods of screening and other important outcomes such as identification of high-risk pancreatic lesions, new-onset diabetes and survival of affected patients.”
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Silva-Santisteban A, et al. Results of first round of enrollment from the screening for pancreatic cancer in high-risk individuals (pancreas scan study): A prospective multicenter study. Presented at: ACG Annual Scientific Meeting; Oct. 21-26, 2022; Charlotte, N.C. (hybrid meeting).
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