Cited by 113Pancreatic and Hepatic Oncology ResearchGlobal Cancer Incidence and ScreeningPancreatitis Pathology and Treatment

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Diagnostic Yield From Screening Asymptomatic Individuals at High Risk for Pancreatic Cancer: A Meta-analysis of Cohort Studies

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Corral, Juan E., Mareth, Karl F., Riegert-Johnson, Douglas L., Das, Ananya, Wallace, Michael B.·2019·Clinical Gastroenterology and Hepatology

DOI 10.1016/j.cgh.2018.04.065

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Abstract

Background & aims There have been few studies of abdominal imaging screening of individuals at high risk for pancreatic cancer (based on family history or genetic variants). We performed a meta-analysis of prospective cohort studies to determine the diagnostic yield and outcomes of abdominal imaging screening for asymptomatic individuals at high risk.Methods Through a systematic review of multiple electronic databases and conference proceedings through July 2017, we identified prospective cohort studies (>20 patients) of asymptomatic adults determined to be at high-risk of pancreatic cancer (lifetime risk >5%, including specific genetic-associated conditions) who were screened by endoscopic ultrasound (EUS) and/or magnetic resonance imaging (MRI) to detect pancreatic lesions. Our primary outcome was identification of high-risk pancreatic lesions (high-grade pancreatic intraepithelial neoplasia, high-grade dysplasia, or adenocarcinoma) at initial screening, and overall incidence during follow up. Summary estimates were reported as incidence rates per 100 patient-years.Results We identified 19 studies comprising 7085 individuals at high risk for pancreatic cancer; of these, 1660 patients were evaluated by EUS and/or MRI. Fifty-nine high-risk lesions were identified (43 adenocarcinomas: 28 during the initial exam and 15 during follow-up surveillance) and 257 patients underwent pancreatic surgery. Based on our meta-analysis, the overall diagnostic yield screening for high-risk pancreatic lesions was 0.74 (95% CI, 0.33-1.14), with moderate heterogeneity among studies. The number needed to screen to identify 1 patient with a high-risk lesion was 135 (95% CI, 88-303). The diagnostic yield was similar for patients with different genetic features that increased risk, and whether patients were screened by EUS or MRI.Conclusions Based on meta-analysis, 135 patients at high-risk for pancreatic cancer must be screened to identify 1 patient with a high-risk pancreatic lesion. Further studies are needed to determine whether screening reduces mortality and is cost effectiveness for individuals at high-risk of pancreatic cancer.

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Authors: Corral, J. E., Mareth, K. F., Riegert-Johnson, D. L., Das, A., & Wallace, M. B.
Affiliations: Mayo Clinic (US)
St. Joseph's Hospital and Medical Center (US)
Corresponding author: Wallace, Michael B.
ORCID: Corral, Juan E.
Mareth, Karl F.
Das, Ananya
Wallace, Michael B.
Venue: Clinical Gastroenterology and Hepatology
Publisher: Elsevier BV
Published: 2019-01
Volume: 17
Issue: 1
Pages: 41-53
ISSN: 1542-3565 (ISSN-L)
DOI: 10.1016/j.cgh.2018.04.065
OpenAlex: W2809523459
Cited by: 113
References: 49
Citations by year: 2026: 12 · 2025: 9 · 2024: 13 · 2023: 19 · 2022: 14 · 2021: 16 · 2020: 14 · 2019: 10
FWCI: 1.20
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Clinical Gastroenterology and Hepatology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
Keywords: pancreatic cancer screening, high-risk individuals, endoscopic ultrasound, magnetic resonance imaging, diagnostic yield, pancreatic intraepithelial neoplasia, pancreatic ductal adenocarcinoma, pancreatic dysplasia, genetic susceptibility, family history (medicine), surveillance (medicine), number needed to screen
MeSH terms: Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Pancreatic Neoplasms, Incidence, Early Detection of Cancer, Young Adult, Asymptomatic Diseases, Optical Imaging

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Diagnostic Yield From Screening Asymptomatic Individuals at High Risk for Pancreatic Cancer: A Meta-analysis of Cohort Studies

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