Screening for Pancreatic Cancer

Abstract

US Preventive Services Task Force T he US Preventive Services Task Force (USPSTF) makes recommendations about the effectiveness of specific preventive care services for patients without obvious related signs or symptoms.It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. The USPSTF does not consider the costs of providing a service in this assessment.The USPSTF recognizes that clinical decisions involve more considerations than evidence alone. Clinicians should understand the evidence but individualize decision making to the specific patient or situation. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms. Summary of Recommendation and EvidenceThe USPSTF recommends against screening for pancreatic cancer in asymptomatic adults (D recommendation) (Figure 1). RationaleImportance Pancreatic ductal adenocarcinoma (referred to hereafter as pancreatic cancer) is an uncommon cancer with an age-adjusted annual incidence of 12.9 cases per 100 000 person-years. However, the death rate is 11.0 deaths per 100 000 person-years IMPORTANCE Pancreatic cancer is an uncommon cancer with an age-adjusted annual incidence of 12.9 cases per 100 000 person-years. However, the death rate is 11.0 deaths per 100 000 person-years because the prognosis of pancreatic cancer is poor. Although its incidence is low, pancreatic cancer is the third most common cause of cancer death in the United States. Because of the increasing incidence of pancreatic cancer, along with improvements in early detection and treatment of other types of cancer, it is estimated that pancreatic cancer may soon become the second-leading cause of cancer death in the United States.OBJECTIVE To update the 2004 US Preventive Services Task Force (USPSTF) recommendation on screening for pancreatic cancer. EVIDENCE REVIEWThe USPSTF reviewed the evidence on the benefits and harms of screening for pancreatic cancer, the diagnostic accuracy of screening tests for pancreatic cancer, and the benefits and harms of treatment of screen-detected or asymptomatic pancreatic cancer.FINDINGS The USPSTF found no evidence that screening for pancreatic cancer or treatment of screen-detected pancreatic cancer improves disease-specific morbidity or mortality, or all-cause mortality. The USPSTF found adequate evidence that the magnitude of the benefits of screening for pancreatic cancer in asymptomatic adults can be bounded as no greater than small. The USPSTF found adequate evidence that the magnitude of the harms of screening for pancreatic cancer and treatment of screen-detected pancreatic cancer can be bounded as at least moderate. The USPSTF reaffirms its previous conclusion that the potential benefits of screening for pancreatic cancer in asymptomatic adults do not outweigh the potential harms. CONCLUSIONS AND RECOMMENDATIONThe USPSTF recommends against screening for pancreatic cancer in asymptomatic adults. (D recommendatio...

Insight into the effects of microRNA‑23a‑3p on pancreatic cancer and its underlying molecular mechanism

“…Pancreatic cancer (PC) is considered as a fatal disease and is the third leading cause of cancer-associated mortality in United States in 2019 (1). The overall 5-year survival rate was 9.3% between 2009 and 2015 in United States (1).…”

“…Pancreatic cancer (PC) is considered as a fatal disease and is the third leading cause of cancer-associated mortality in United States in 2019 (1). The overall 5-year survival rate was 9.3% between 2009 and 2015 in United States (1). Compared with other types of cancer, the early diagnostic rate of PC is low, which remains to be one of the critical factors contributing to its dismal prognosis (2).…”

The burden of pancreatic cancer is rising in Brazil

“…9 People with pancreatic cancer have not benefited from recent improvements in overall survival relating to genetic profiling ("precision medicine"), 10 and no screening tool has been proven to be effective for early diagnosis of pancreatic cancer. 11…”

Bratislava Statement: consensus recommendations for improving pancreatic cancer care

“…This is mainly due to the advanced stage of most tumours at diagnosis, which in turn stems from the late and non-specific symptomatology and the lack of any effective screening tests. 15 ► Pancreatic surgery plus perioperative therapy (current standard of care: adjuvant chemotherapy) is the only potentially curative treatment, but just 20% of patients-at most-are candidates for this approach. 3 4 Furthermore, pancreatic surgery is among the most technically complex and risky interventions that a patient can undergo.…”