A cost analysis of a pancreatic cancer screening protocol in high-risk populations

Abstract

Background Pancreatic cancer is the 4th leading cause of cancer death in the U.S. A screening protocol is needed to catch early stage, resectable disease. This study suggests a protocol for high-risk individuals and assesses the cost in the context of the Affordable Care Act. Methods Medicare and national average pricing were used for cost analysis of a protocol using MRI/MRCP biannually in high-risk groups. Results: ‘ Costs per year of life added’ based on Medicare and national average costs, respectively, are: $638.62 and $2542.37 for Peutz-Jehgers Syndrome, $945.33 and $3763.44 for Hereditary Pancreatitis, $1141.77 and $4545.45 for Familial Pancreatic Cancer and p16-Leiden mutations, and $356.42 and $1418.92 for new-onset diabetes over age 50 with weight loss or smoking. Conclusion A screening program using MRI/MRCP is affordable in high-risk populations. The U.S. Preventive Services Task Force must reevaluate its pancreatic cancer screening guidelines to make screening more cost-effective for the individual.

State-Of-The-Art Endoscopic Procedures for Pancreatic Cancer

“…10.2217/fon-2016-0123 review Coronel & Waxman future science group 241 patients with solid pancreatic lesions showed that the use of immediate OCE does lead to fewer needle passes (OCE = 4 vs no OCE = 7; p < 0.0001), but does not improve the diagnostic yield of malignancy and proportion of specimen adequacy. In addition, the use of immediate OCE did not affect overall procedure time, adverse events rates, number of repeat procedures, cost and sample quality [37].…”

“…The relatively low incidence of pancreatic cancer make population-wide screening a nonviable option since it is unpractical and costly [7,8]. As such, there is ongoing research invested to identify at risk populations to apply cost-effective screening strategies [7,[9][10].…”

Hereditary Pancreatic Cancer

“…Costs of screening protocols in individuals at risk for pancreatic cancer development have been examined and appears to be cost-effective [80]. Utilizing early detection programs through several institutions may define better the risk factors for pancreatic cancer along with initiating clinical trials for earlier intervention.…”

Familial Pancreatic Cancer

“…Additionally, the risk of rising costs without helpful results or benefits due to pancreatic cancer screening programs is possible [100]. Psychoanalytical aspects for participants in screening programs have been studied and show that the distribution of anxiety and depression are similar to those in the normal populations, although a third worry about cancer [101,102].…”

“…The costs of these screening programs are affordable with respect to MRI and MRCP for patients with higher risk of development of PDAC, and specialization is important for effectiveness [100,109]. Nevertheless, it is important to reform the guidelines for screening to be more cost effective [100]. …”