The DOI matches its Crossref record; 124 of the 127 references it cites were found in a registry or an index, and 1 are not checked yet; 10 of the 155 sources its claims cite were checked for support.
Early detection of pancreatic cancer
Open accessAbstract
Pancreatic ductal adenocarcinoma is most frequently detected at an advanced stage. Such late detection restricts treatment options and contributes to a dismal 5-year survival rate of 3–15%. Pancreatic ductal adenocarcinoma is relatively uncommon and screening of the asymptomatic adult population is not feasible or recommended with current modalities. However, screening of individuals in high-risk groups is recommended. Here, we review groups at high risk for pancreatic ductal adenocarcinoma, including individuals with inherited predisposition and patients with pancreatic cystic lesions. We discuss studies aimed at finding ways of identifying pancreatic ductal adenocarcinoma in high-risk groups, such as among individuals with new-onset diabetes mellitus and people attending primary and secondary care practices with symptoms that suggest this cancer. We review early detection biomarkers, explore the potential of using social media for detection, appraise prediction models developed using electronic health records and research data, and examine the application of artificial intelligence to medical imaging for the purposes of early detection.
Verified 2026-10-06 · 1 reference not checked yet
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88 Not checked yet · 29 Own interpretation · 3 Partly supported · 2 Mixed support · 2 Sources not found · 1 Couldn’t confirm · 1 No basis given · accuracy not yet measured
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“25% of patients who have a presumed mucinous cystic lesion removed are ultimately found to have a cyst with no malignant potential,39”
§ Early detection of pancreatic cancer > High-risk groups > Cystic lesions
What the sources say
- Could not verifycites [39] Valsangkar NP, Morales-Oyarvide V, Thayer SP, 851 resected cystic tumors of the pancreas: a 33-year experience at the Massachusetts General Hospital. Surgery 2012; 152 (suppl 1): S4– 12. 22770958 PMC3806101 sourceExperimental — accuracy not yet measured
The Results (Demographic characteristics; page unavailable) give final diagnoses among all 851 resected cysts, not outcomes for patients whose lesions were presumed mucinous before surgery. The Discussion (page unavailable) addresses malignancy and dysplasia but gives no 25% figure for cysts with no malignant potential. Searches for preoperative mucinous diagnoses and that percentage found no comparison that verifies the claim. (LLM, conf=0.76)
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In the paper
“and exocrine insufficiency appears to be a contributing cause.116”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Deep learning methodologies applied to abdominal imaging
What the sources say
- Partly supportedcites [116] Danai LV, Babic A, Rosenthal MH, Altered exocrine function can drive adipose wasting in early pancreatic cancer. Nature 2018; 558: 600– 04. 29925948 PMC6112987 sourceExperimental — accuracy not yet measured
The paper reports that decreased exocrine function contributes to adipose-tissue wasting in PDAC mouse models (Abstract), supporting a contribution to weight loss. It explicitly says whether this mechanism contributes to wasting in patients requires further study, and enzyme replacement did not significantly affect muscle loss; the broader claim about weight loss in PDAC is therefore not fully established. (LLM, conf=0.86)
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In the paper
“Similarly, incidentally diagnosed pancreatic ductal adenocarcinoma (ie, discovered serendipitously while screening or checking for other diseases) is associated with longer median survival than pancreatic ductal adenocarcinoma that is diagnosed when patients have symptoms.8”
§ Early detection of pancreatic cancer > Introduction
What the sources say
- Not checked yetcites [8] Poruk KE, Firpo MA, Adler DG, Mulvihill SJ. Screening for pancreatic cancer: why, how, and who? Ann Surg 2013; 257: 17– 26. 22895395 PMC4113008 source
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In the paper
“Patients diagnosed with stage 1 disease experience longer survival times than patients diagnosed with disease at more advanced stages.8”
§ Early detection of pancreatic cancer > Introduction
What the sources say
- Not checked yetcites [8] Poruk KE, Firpo MA, Adler DG, Mulvihill SJ. Screening for pancreatic cancer: why, how, and who? Ann Surg 2013; 257: 17– 26. 22895395 PMC4113008 source
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In the paper
“Unfortunately, up to 85% of patients have cancers that are not surgically resectable when identified, and over half of patients in the UK are diagnosed following a non-specific disease course leading to an emergency hospital admission.10–13”
§ Early detection of pancreatic cancer > Introduction
What the sources say
- Not checked yetcites [10] Keane MG, Horsfall L, Rait G, Pereira SP. A case-control study comparing the incidence of early symptoms in pancreatic and biliary tract cancer. BMJ Open 2014; 4: e005720. PMC4244441 25410605 source
- Not checked yetcites [11] Zhou Y, Abel GA, Hamilton W, Diagnosis of cancer as an emergency: a critical review of current evidence. Nat Rev Clin Oncol 2017; 14: 45– 56. 27725680 source
- Not checked yetcites [12] Hippisley-Cox J, Coupland C. Identifying patients with suspected pancreatic cancer in primary care: derivation and validation of an algorithm. Br J Gen Pract 2012; 62: e38– 45. 22520674 PMC3252538 source
- Not checked yetcites [13] Stapley S, Peters TJ, Neal RD, Rose PW, Walter FM, Hamilton W. The risk of pancreatic cancer in symptomatic patients in primary care: a large case-control study using electronic records. Br J Cancer 2012; 106: 1940– 44. 22617126 PMC3388562 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“a dismal 5-year survival rate of 3–15%”
- Also stated in: § Introduction · plain
“the 5-year survival rates remain as low as 3–15%.3,4”
§ Early detection of pancreatic cancer > Abstract
What the sources say
- Not checked yetcites [3] Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394– 424. 30207593
- Not checked yetcites [4] Arnold M, Rutherford MJ, Bardot A, Progress in cancer survival, mortality, and incidence in seven high-income countries 1995–2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol 2019; 20: 1493– 505. 31521509 PMC6838671 source
plain- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Introduction · plain
None of the sources cited for this claim have been checked yet.
In the paper
“over half of patients in the UK are diagnosed following a non-specific disease course leading to an emergency hospital admission.10–13”
§ Early detection of pancreatic cancer > Introduction
What the sources say
- Not checked yetcites [10] Keane MG, Horsfall L, Rait G, Pereira SP. A case-control study comparing the incidence of early symptoms in pancreatic and biliary tract cancer. BMJ Open 2014; 4: e005720. PMC4244441 25410605 source
- Not checked yetcites [11] Zhou Y, Abel GA, Hamilton W, Diagnosis of cancer as an emergency: a critical review of current evidence. Nat Rev Clin Oncol 2017; 14: 45– 56. 27725680 source
- Not checked yetcites [12] Hippisley-Cox J, Coupland C. Identifying patients with suspected pancreatic cancer in primary care: derivation and validation of an algorithm. Br J Gen Pract 2012; 62: e38– 45. 22520674 PMC3252538 source
- Not checked yetcites [13] Stapley S, Peters TJ, Neal RD, Rose PW, Walter FM, Hamilton W. The risk of pancreatic cancer in symptomatic patients in primary care: a large case-control study using electronic records. Br J Cancer 2012; 106: 1940– 44. 22617126 PMC3388562 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Survival rates are also substantially better for patients diagnosed at an operable rather than an inoperable stage.9”
§ Early detection of pancreatic cancer > Introduction
What the sources say
- Not checked yetcites [9] Neoptolemos JP, Kleeff J, Michl P, Costello E, Greenhalf W, Palmer DH. Therapeutic developments in pancreatic cancer: current and future perspectives. Nat Rev Gastroenterol Hepatol 2018; 15: 333– 48. 29717230 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“This spectrum seems to be similar in families affected by HBOC, whether or not they have an increased incidence of pancreatic ductal adenocarcinoma.34”
§ Early detection of pancreatic cancer > High-risk groups > Familial or inherited risk
What the sources say
- Not checked yetcites [34] Rebbeck TR, Friebel TM, Friedman E, Mutational spectrum in a worldwide study of 29 700 families with BRCA1 or BRCA2 mutations. Hum Mutat 2018; 39: 593– 620. 29446198 PMC5903938
hedged- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The low disease prevalence makes screening of the asymptomatic adult population unfeasible.”
§ Early detection of pancreatic cancer > Introduction
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“When the causative mutation is known,26 it segregates with the disease.”
§ Early detection of pancreatic cancer > High-risk groups > Familial or inherited risk
What the sources say
- Not checked yetcites [26] Hahn SA, Greenhalf B, Ellis I, BRCA2 germline mutations in familial pancreatic carcinoma. J Natl Cancer Inst 2003; 95: 214– 21. 12569143 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“up to 78% of individuals with branch duct intraductal papillary mucinous neoplasms that undergo surgical resection do not have high-grade dysplasia or pancreatic ductal adenocarcinoma and in hindsight did not require surgery.40”
§ Early detection of pancreatic cancer > High-risk groups > Cystic lesions
What the sources say
- Not checked yetcites [40] Sahora K, Mino-Kenudson M, Brugge W, Branch duct intraductal papillary mucinous neoplasms: does cyst size change the tip of the scale? A critical analysis of the revised international consensus guidelines in a large single-institutional series. Ann Surg 2013; 258: 466– 75. 24022439 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Pancreatic cysts are found in approximately 8% of individuals older than 70 years.38”
§ Early detection of pancreatic cancer > High-risk groups > Cystic lesions
What the sources say
- Not checked yetcites [38] Lee KS, Sekhar A, Rofsky NM, Pedrosa I. Prevalence of incidental pancreatic cysts in the adult population on MR imaging. Am J Gastroenterol 2010; 105: 2079– 84. 20354507 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“However, the absence of a family history in individuals with the same specific mutations indicates that these mutations are context-specific.29”
§ Early detection of pancreatic cancer > High-risk groups > Familial or inherited risk
What the sources say
- Not checked yetcites [29] Hu C, Hart SN, Polley EC, Association between inherited germline mutations in cancer predisposition genes and risk of pancreatic cancer. JAMA 2018; 319: 2401– 09. 29922827 PMC6092184 source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“families with a strong history of pancreatic ductal adenocarcinoma mostly do not have mutations in the genes known to be associated with the disease.26,27,29,30”
§ Early detection of pancreatic cancer > High-risk groups > Familial or inherited risk
What the sources say
- Not checked yetcites [26] Hahn SA, Greenhalf B, Ellis I, BRCA2 germline mutations in familial pancreatic carcinoma. J Natl Cancer Inst 2003; 95: 214– 21. 12569143 source
- Not checked yetcites [27] Slater EP, Langer P, Niemczyk E, PALB2 mutations in European familial pancreatic cancer families. Clin Genet 2010; 78: 490– 94. 20412113 source
- Not checked yetcites [29] Hu C, Hart SN, Polley EC, Association between inherited germline mutations in cancer predisposition genes and risk of pancreatic cancer. JAMA 2018; 319: 2401– 09. 29922827 PMC6092184 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Existing diagnostic methods would incur unacceptably high rates of false-positive findings,16”
§ Early detection of pancreatic cancer > Introduction
What the sources say
- Not checked yetcites [16] Hart PA, Chari ST. Is screening for pancreatic cancer in high-risk individuals one step closer or a fool’s errand? Clin Gastroenterol Hepatol 2019; 17: 36– 38. 30268560 PMC6557281 source
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In the paper
“Overall, almost two-thirds of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms harbour a mutation in KRAS or GNAS in the cyst fluid.41”
§ Early detection of pancreatic cancer > High-risk groups > Cystic lesions
What the sources say
- Not checked yetcites [41] Springer S, Masica DL, Dal Molin M, A multimodality test to guide the management of patients with a pancreatic cyst. Sci Transl Med 2019; 11: eaav4772. 31316009 PMC7859881 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Registries of such high-risk families indicate a roughly 50% lifetime risk, regardless of whether a causative mutation is known,31”
§ Early detection of pancreatic cancer > High-risk groups > Familial or inherited risk
What the sources say
- Not checked yetcites [31] Greenhalf W, Malats N, Nilsson M, Bartsch D, Neoptolemos J. International registries of families at high risk of pancreatic cancer. Pancreatology 2008; 8: 558– 65. 18818508 source
hedged- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“germline mutations in specific genes are associated with developing the condition.26–28”
§ Early detection of pancreatic cancer > High-risk groups > Familial or inherited risk
What the sources say
- Not checked yetcites [26] Hahn SA, Greenhalf B, Ellis I, BRCA2 germline mutations in familial pancreatic carcinoma. J Natl Cancer Inst 2003; 95: 214– 21. 12569143 source
- Not checked yetcites [27] Slater EP, Langer P, Niemczyk E, PALB2 mutations in European familial pancreatic cancer families. Clin Genet 2010; 78: 490– 94. 20412113 source
- Not checked yetcites [28] Mukherjee B, Delancey JO, Raskin L, Risk of non-melanoma cancers in first-degree relatives of CDKN2A mutation carriers. J Natl Cancer Inst 2012; 104: 953– 56. 22534780 PMC3379723 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“the mutations are almost as frequent in sporadic disease as in individuals with a family history.29”
§ Early detection of pancreatic cancer > High-risk groups > Familial or inherited risk
What the sources say
- Not checked yetcites [29] Hu C, Hart SN, Polley EC, Association between inherited germline mutations in cancer predisposition genes and risk of pancreatic cancer. JAMA 2018; 319: 2401– 09. 29922827 PMC6092184 source
plain- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“A family history of the disease is a risk factor for development of pancreatic ductal adenocarcinoma,24,25”
§ Early detection of pancreatic cancer > High-risk groups > Familial or inherited risk
What the sources say
- Not checked yetcites [24] Fernandez E, La Vecchia C, D’Avanzo B, Negri E, Franceschi S. Family history and the risk of liver, gallbladder, and pancreatic cancer. Cancer Epidemiol Biomarkers Prev 1994; 3: 209– 12. 8019368 source
- Not checked yetcites [25] Hamada T, Yuan C, Yurgelun MB, Family history of cancer, Ashkenazi Jewish ancestry, and pancreatic cancer risk. Br J Cancer 2019; 120: 848– 54. 30867564 PMC6474278 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Identification of mucinous cystic lesions therefore offers the potential for early detection of pancreatic ductal adenocarcinoma.”
§ Early detection of pancreatic cancer > High-risk groups > Cystic lesions
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Rests on an assumption: Not all pancreatic cystic lesions are intraductal papillary mucinous neoplasms or mucinous cystic neoplasms; many have no risk of malignant transformation and do not require surveillance.
- Rests on an assumption: Most intraductal papillary mucinous neoplasms and mucinous cystic neoplasms do not progress to pancreatic ductal adenocarcinoma.
In the paper
“However, in individuals who have had type 2 diabetes for less than 1 year, the relative risk of pancreatic ductal adenocarcinoma increases to 5·4-fold,47”
§ Early detection of pancreatic cancer > High-risk groups > New-onset diabetes mellitus
What the sources say
- Not checked yetcites [47] Ben Q, Xu M, Ning X, Diabetes mellitus and risk of pancreatic cancer: a meta-analysis of cohort studies. Eur J Cancer 2011; 47: 1928– 37. 21458985
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Preliminary studies evaluating the presence of mutations in PIK3CA, SMAD4, and TP53 in cyst fluid were promising, as they identified almost 80% of intraductal papillary mucinous neoplasms with high-grade dysplasia or cancer.43”
§ Early detection of pancreatic cancer > High-risk groups > Cystic lesions
What the sources say
- Not checked yetcites [43] Singhi AD, McGrath K, Brand RE, Preoperative next-generation sequencing of pancreatic cyst fluid is highly accurate in cyst classification and detection of advanced neoplasia. Gut 2018; 67: 2131– 41. 28970292 PMC6241612 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is probable that the genetic risk is multigenic for most people;”
§ Early detection of pancreatic cancer > High-risk groups > Familial or inherited risk
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“Even in families affected by HBOC with no BRCA2 (or BRCA1) mutation, the risk of pancreatic ductal adenocarcinoma is greatly elevated.35”
§ Early detection of pancreatic cancer > High-risk groups > Familial or inherited risk
What the sources say
- Not checked yetcites [35] Wendt C, Lindblom A, Arver B, von Wachenfeldt A, Margolin S. Tumour spectrum in non-BRCA hereditary breast cancer families in Sweden. Hered Cancer Clin Pract 2015; 13: 15. 26082817 PMC4469256 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Studies have shown good sensitivity with excellent specificity for differentiating between benign cysts that require no follow-up and intraductal papillary mucinous neoplasms.44–46”
§ Early detection of pancreatic cancer > High-risk groups > Cystic lesions
What the sources say
- Not checked yetcites [44] Krishna SG, Hart PA, Malli A, Endoscopic ultrasound-guided confocal laser endomicroscopy increases accuracy of differentiation of pancreatic cystic lesions. Clin Gastroenterol Hepatol 2019; published online Jun 18. DOI: 10.1186/S1542-3565(19)30648-2. 31220640 source
- Not checked yetcites [45] Napoleon B, Palazzo M, Lemaistre AI, Needle-based confocal laser endomicroscopy of pancreatic cystic lesions: a prospective multicenter validation study in patients with definite diagnosis. Endoscopy 2019; 51: 825– 35. 30347425 source
- Not checked yetcites [46] Keane MG, Wehnert N, Perez-Machado M, A prospective trial of CONfocal endomicroscopy in CYSTic lesions of the pancreas: CONCYST-01. Endosc Int Open 2019; 7: E1117– 22. 31475228 PMC6715431 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“with substantial research pointing towards pancreatic ductal adenocarcinoma-induced hyperglycaemia and diabetes.48”
§ Early detection of pancreatic cancer > High-risk groups > New-onset diabetes mellitus
What the sources say
- Not checked yetcites [48] Hart PA, Bellin MD, Andersen DK, Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. Lancet Gastroenterol Hepatol 2016; 1: 226– 37. 28404095 PMC5495015 source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“With the exception of jaundice, weight loss, and new-onset diabetes, which indicate a considerably increased risk, most individual risk factors or symptoms (eg, dyspepsia, bloating, change in bowel habit) only provide a modest (1·5-fold to 3-fold) increased risk of developing pancreatic ductal adenocarcinoma.10,54”
§ Early detection of pancreatic cancer > Practicalities of screening > Who should be screened?
What the sources say
- Not checked yetcites [10] Keane MG, Horsfall L, Rait G, Pereira SP. A case-control study comparing the incidence of early symptoms in pancreatic and biliary tract cancer. BMJ Open 2014; 4: e005720. PMC4244441 25410605 source
- Not checked yetcites [54] Kenner BJ, Chari ST, Cleeter DF, Go VL. Early detection of sporadic pancreatic cancer: strategic map for innovation—a white paper. Pancreas 2015; 44: 686– 92. 25938853 PMC4467583 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“All screening programmes for pancreatic ductal adenocarcinoma aim to detect and treat T1N0M0 cancers or high-grade dysplastic premalignant lesions (ie, pancreatic intraepithelial neoplasia 3 or mucinous cystic tumours with high-grade dysplasia).6,54”
§ Early detection of pancreatic cancer > Practicalities of screening > How should individuals be screened?
What the sources say
- Not checked yetcites [6] Canto MI, Harinck F, Hruban RH, International Cancer of the Pancreas Screening (CAPS) Consortium summit on the management of patients with increased risk for familial pancreatic cancer. Gut 2013; 62: 339– 47. 23135763 PMC3585492 source
- Not checked yetcites [54] Kenner BJ, Chari ST, Cleeter DF, Go VL. Early detection of sporadic pancreatic cancer: strategic map for innovation—a white paper. Pancreas 2015; 44: 686– 92. 25938853 PMC4467583 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“This concern does not apply to other common cancers, where the prevalence of diabetes is similar to that in people without cancer.51”
§ Early detection of pancreatic cancer > High-risk groups > New-onset diabetes mellitus
What the sources say
- Not checked yetcites [51] Aggarwal G, Kamada P, Chari ST. Prevalence of diabetes mellitus in pancreatic cancer compared to common cancers. Pancreas 2013; 42: 198– 201. 23000893 PMC3896296 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“When diagnosed with pancreatic ductal adenocarcinoma, around 80% of patients have abnormal fasting glucose or glucose intolerance.49,50”
§ Early detection of pancreatic cancer > High-risk groups > New-onset diabetes mellitus
What the sources say
- Not checked yetcites [49] Permert J, Ihse I, Jorfeldt L, von Schenck H, Arnqvist HJ, Larsson J. Pancreatic cancer is associated with impaired glucose metabolism. Eur J Surg 1993; 159: 101– 07. 8098623
- Not checked yetcites [50] Pannala R, Leirness JB, Bamlet WR, Basu A, Petersen GM, Chari ST. Prevalence and clinical profile of pancreatic cancer-associated diabetes mellitus. Gastroenterology 2008; 134: 981– 87. 18395079 PMC2323514 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Thus, new-onset diabetes can be considered an early warning sign of pancreatic ductal adenocarcinoma,22”
§ Early detection of pancreatic cancer > High-risk groups > New-onset diabetes mellitus
What the sources say
- Not checked yetcites [22] Andersen DK, Korc M, Petersen GM, Diabetes, pancreatogenic diabetes, and pancreatic cancer. Diabetes 2017; 66: 1103– 10. 28507210 PMC5399609 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“These synthetic biomarkers have advantages over endogenous biomarkers (eg, CA19–9).”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Synthetic biomarkers
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In the paper
“Most major studies now incorporate control samples from patients with different diseases, such as chronic pancreatitis.68”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Challenges and opportunities
What the sources say
- Not checked yetcites [68] Jenkinson C, Earl J, Ghaneh P, Biomarkers for early diagnosis of pancreatic cancer. Expert Rev Gastroenterol Hepatol 2015; 9: 305– 15. 25373768 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Proof of concept has been shown in several settings, including early detection of ovarian cancer in mouse models through use of cleavable substrates by upregulated proteases in the tumour microenvironment,89”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Synthetic biomarkers
What the sources say
- Not checked yetcites [89] Kwon EJ, Dudani JS, Bhatia SN. Ultrasensitive tumour-penetrating nanosensors of protease activity. Nat Biomed Eng 2017; 1: 0054. 28970963 PMC5621765 source
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In the paper
“To address this delay, primary care doctors in the UK are gaining greater access to diagnostic investigations, including CT or rapid referral clinics (such as the newly developed multidisciplinary diagnostic centres),65 which enable the rapid assessment of patients with concerning but non-specific symptoms.”
§ Early detection of pancreatic cancer > Practicalities of screening > How should individuals be screened?
What the sources say
- Not matchedcites [65] Cancer Research UK. Accelerate, Coordinate, Evaluate (ACE) programme. 2019 https://www.cancerresearchuk.org/health-professional/diagnosis/accelerate-coordinate-evaluate-ace-programme/multidisciplinary-diagnostic-centres-mdcs (accessed Sept 2, 2019).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
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- Not matched
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In the paper
“Moreover, awareness that the presence of obstructive jaundice can lead to false-positive biomarker findings is increasing.69–71”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Challenges and opportunities
What the sources say
- Not checked yetcites [69] Yan L, Tonack S, Smith R, Confounding effect of obstructive jaundice in the interpretation of proteomic plasma profiling data for pancreatic cancer. J Proteome Res 2009; 8: 142– 48. 19055369 source
- Not checked yetcites [70] Tonack S, Jenkinson C, Cox T, iTRAQ reveals candidate pancreatic cancer serum biomarkers: influence of obstructive jaundice on their performance. Br J Cancer 2013; 108: 1846– 53. 23579209 PMC3658525 source
- Not checked yetcites [71] Nie S, Lo A, Wu J, Glycoprotein biomarker panel for pancreatic cancer discovered by quantitative proteomics analysis. J Proteome Res 2014; 13: 1873– 84. 24571389 PMC3993962 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“only 65% of patients with resectable pancreatic ductal adenocarcinoma have elevated serum levels of CA19–9,77”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Current promising biomarkers for early detection
What the sources say
- Not checked yetcites [77] Goggins M Molecular markers of early pancreatic cancer. J Clin Oncol 2005; 23: 4524– 31. 16002843 source
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In the paper
“Lee and colleagues78 reported an improved area under receiver operating characteristic curve (AUC) using a combination of CA19–9 and cell migration-inducing hyaluronan binding protein (CEMIP; a protein involved in the degradation of hyaluronan) compared with using CA19–9 alone (AUC=0·94 vs 0·89).”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Current promising biomarkers for early detection
What the sources say
- Not checked yetcites [78] Lee HS, Jang CY, Kim SA, Combined use of CEMIP and CA 19–9 enhances diagnostic accuracy for pancreatic cancer. Sci Rep 2018; 8: 3383. 29467409 PMC5821821 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Ghatnekar and colleagues74 developed a framework for modelling cost and quality-adjusted life-years of serum biomarker-mediated early detection of pancreatic ductal adenocarcinoma in individuals with new-onset diabetes.”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Challenges and opportunities
What the sources say
- Not checked yetcites [74] Ghatnekar O, Andersson R, Svensson M, Modelling the benefits of early diagnosis of pancreatic cancer using a biomarker signature. Int J Cancer 2013; 133: 2392– 97. 23649606 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“and identification of residual cancer after surgery in humans through a protease-activated fluorescent probe.91”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Synthetic biomarkers
What the sources say
- Not checked yetcites [91] Whitley MJ, Cardona DM, Lazarides AL, A mouse-human phase 1 co-clinical trial of a protease-activated fluorescent probe for imaging cancer. Sci Transl Med 2016; 8: 320ra4. PMC4794335 26738797 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“As both true-positive and false-positive tests require further investigation, high specificity biomarkers are required.”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Challenges and opportunities
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Pancreatic tumours are highly heterogeneous, both within and between individuals.66,67”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Challenges and opportunities
What the sources say
- Not checked yetcites [66] Campbell PJ, Yachida S, Mudie LJ, The patterns and dynamics of genomic instability in metastatic pancreatic cancer. Nature 2010; 467: 1109– 13. 20981101 PMC3137369 source
- Not checked yetcites [67] Yachida S, Jones S, Bozic I, Distant metastasis occurs late during the genetic evolution of pancreatic cancer. Nature 2010; 467: 1114– 17. 20981102 PMC3148940 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Development of synthetic biomarkers for pancreatic ductal adenocarcinoma could substantially impact early detection efforts and other clinical applications in the future.”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Synthetic biomarkers
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“although the incidence of pancreatic ductal adenocarcinoma in this group is predicted to be only 1–2% over a 3-year period.”
§ Early detection of pancreatic cancer > Ongoing trials and studies for early detection
What the sources say
- Not checked yetcites [61] Maitra A, Sharma A, Brand RE, A prospective study to establish a new-onset diabetes cohort: from the consortium for the study of chronic pancreatitis, diabetes, and pancreatic cancer. Pancreas 2018; 47: 1244– 48. 30325864 PMC6432934 source
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In the paper
“Because of the low incidence of pancreatic ductal adenocarcinoma, primary care doctors might see only one patient with the disease every 5 years.”
§ Early detection of pancreatic cancer > Practicalities of screening > How should individuals be screened?
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Markers generated through this process represent aberrant changes at the genetic, transcriptomic, metabolomic, and proteomic level that are associated with the earliest histological stages of development of pancreatic ductal adenocarcinoma (table 1).”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Current promising biomarkers for early detection
What the sources say
- Not checked yetcites table 1
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Importantly, CEMIP correctly diagnosed 68 of 79 patients with pancreatic ductal adenocarcinoma whose CA19–9 concentrations were in the normal range (below 37 U/mL).”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Current promising biomarkers for early detection
What the sources say
- Not checked yetcites [78] Lee HS, Jang CY, Kim SA, Combined use of CEMIP and CA 19–9 enhances diagnostic accuracy for pancreatic cancer. Sci Rep 2018; 8: 3383. 29467409 PMC5821821 source
plaindirectn = 79- Asserted: passes — The authors put it forward as true.
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In the paper
“Using samples from patients already diagnosed with pancreatic ductal adenocarcinoma in biomarker development might result in biomarkers that are indicative of symptomatic disease.”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Current promising biomarkers for early detection
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“sequential activation by tumour acidity and hypoxia for ultrasensitive imaging detection of tumours as small as 1 mm in mice,90”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Synthetic biomarkers
What the sources say
- Not checked yetcites [90] Zheng X, Mao H, Huo D, Wu W, Liu B, Jiang X. Successively activatable ultrasensitive probe for imaging tumor acidity and hypoxia. Nat Biomed Eng 2017; 1: 0057. source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Understanding and accounting for potential confounding factors is an important component of pancreatic ductal adenocarcinoma biomarker development.68”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Challenges and opportunities
What the sources say
- Not checked yetcites [68] Jenkinson C, Earl J, Ghaneh P, Biomarkers for early diagnosis of pancreatic cancer. Expert Rev Gastroenterol Hepatol 2015; 9: 305– 15. 25373768 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Elevated concentrations of carbohydrate antigen 19–9 (CA19–9), the only biomarker routinely used in the management of pancreatic ductal adenocarcinoma, have been shown in samples taken before diagnosis.76”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Current promising biomarkers for early detection
What the sources say
- Not checked yetcites [76] O’Brien DP, Sandanayake NS, Jenkinson C, Serum CA19–9 is significantly upregulated up to 2 years before diagnosis with pancreatic cancer: implications for early disease detection. Clin Cancer Res 2015; 21: 622– 31. 24938522 PMC4181906 source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Ultimately, the most promising early detection strategy will probably come from a discrete panel of biomarkers used in combination with clinical features.”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Current promising biomarkers for early detection
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“For identification of the primary tumour, Fishman and colleagues have described a radiomics-based machine learning algorithm to differentiate pancreatic ductal adenocarcinoma from benign situations (ie, healthy pancreas and pancreatitis), with high specificity and sensitivity.112”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Deep learning methodologies applied to abdominal imaging
What the sources say
- Not checked yetcites [112] Chu LC, Park S, Kawamoto S, Utility of CT radiomics features in differentiation of pancreatic ductal adenocarcinoma from normal pancreatic tissue. AJR Am J Roentgenol 2019; 213: 349– 57. 31012758 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Thus, these models might have insufficient value as the first tool to identify people who need further work-up for pancreatic ductal adenocarcinoma risk.”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on electronic health records
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“EUROPAC quantified that the lifetime risk of pancreatic ductal adenocarcinoma in hereditary pancreatitis is approximately 40%.97”
§ Early detection of pancreatic cancer > Ongoing trials and studies for early detection
What the sources say
- Not checked yetcites [97] Grocock CJ, Rebours V, Delhaye MN, The variable phenotype of the p.A16V mutation of cationic trypsinogen (PRSS1) in pancreatitis families. Gut 2010; 59: 357– 63. 19951905 source
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“A model based on patients with new-onset diabetes residing in Minnesota, USA, incorporated age at onset of diabetes and changes in weight and blood glucose to identify people with a 4·5% 3-year predicted risk of developing pancreatic ductal adenocarcinoma, with 78% sensitivity and 80% specificity (AUC 0·87).103”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on electronic health records
What the sources say
- Not checked yetcites [103] Sharma A, Kandlakunta H, Nagpal SJS, Model to determine risk of pancreatic cancer in patients with new-onset diabetes. Gastroenterology 2018; 155: 730– 739.e3. 29775599 PMC6120785 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Other applications of radiomics and quantitative imaging approaches have shown that the enhancement and morphology of the primary tumours have biological underpinnings and clinical relevance,113–115”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Deep learning methodologies applied to abdominal imaging
What the sources say
- Not checked yetcites [113] Amer AM, Zaid M, Chaudhury B, Imaging-based biomarkers: changes in the tumor interface of pancreatic ductal adenocarcinoma on computed tomography scans indicate response to cytotoxic therapy. Cancer 2018; 124: 1701– 09. 29370450 PMC5891375 source
- Not checked yetcites [114] Koay EJ, Lee Y, Cristini V, A visually apparent and quantifiable CT imaging feature identifies biophysical subtypes of pancreatic ductal adenocarcinoma. Clin Cancer Res 2018; 24: 5883– 94. 30082477 PMC6279613 source
- Not checked yetcites [115] Koay EJ, Truty MJ, Cristini V, Transport properties of pancreatic cancer describe gemcitabine delivery and response. J Clin Invest 2014; 124: 1525– 36. 24614108 PMC3973100 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“A retrospective review of CT scans done for other indications showed no evidence of a pancreatic mass in most patients 6 months or earlier before the diagnosis of pancreatic ductal adenocarcinoma.120,121”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Artificial intelligence-assisted CT methods and novel MRI methods
What the sources say
- Not checked yetcites [120] Pelaez-Luna M, Takahashi N, Fletcher JG, Chari ST. Resectability of presymptomatic pancreatic cancer and its relationship to onset of diabetes: a retrospective review of CT scans and fasting glucose values prior to diagnosis. Am J Gastroenterol 2007; 102: 2157– 63. 17897335 source
- Not checked yetcites [121] Gangi S, Fletcher JG, Nathan MA, Time interval between abnormalities seen on CT and the clinical diagnosis of pancreatic cancer: retrospective review of CT scans obtained before diagnosis. AJR Am J Roentgenol 2004; 182: 897– 903. 15039161 source
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, there is a need for advanced external body imaging techniques to improve detection of pancreatic ductal adenocarcinoma at an earlier stage than is presently possible.”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Artificial intelligence-assisted CT methods and novel MRI methods
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“This model has been applied to an older population (≥68 years) with new-onset diabetes, and identified people at 3·5% predicted risk of pancreatic ductal adenocarcinoma over 1 year (AUC 0·73).106”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on electronic health records
What the sources say
- Not checked yetcites [106] Baecker A, Kim S, Risch HA, Do changes in health reveal the possibility of undiagnosed pancreatic cancer? Development of a risk-prediction model based on healthcare claims data. PLoS One 2019; 14: e0218580. 31237889 PMC6592596 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“and that diabetes predisposes for cancer in hereditary pancreatitis.100”
§ Early detection of pancreatic cancer > Ongoing trials and studies for early detection
What the sources say
- Not checked yetcites [100] Kolamunnage-Dona R, Vitone L, Greenhalf W, Henderson R, Williamson PR. A multistate modelling approach for pancreatic cancer development in genetically high-risk families. J R Stat Soc C-Appl 2013; 62: 201– 12. source
plaindirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Because information on smoking or drinking intensity and blood type are not readily available in electronic health records, implementation of models based on research data poses some challenges for the general population.”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on research data
hedgeddirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For patients undergoing screening or imaging for reasons other than the pancreas, the measurement of body compartments—especially over time—could provide important metrics in the earlier detection of pancreatic cancer.”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Deep learning methodologies applied to abdominal imaging
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Parametric models that can identify high risk for pancreatic ductal adenocarcinoma among individuals with new-onset diabetes, or new-onset pre-diabetes, have been developed, with varying predictive performances.103–106”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on electronic health records
What the sources say
- Not checked yetcites [103] Sharma A, Kandlakunta H, Nagpal SJS, Model to determine risk of pancreatic cancer in patients with new-onset diabetes. Gastroenterology 2018; 155: 730– 739.e3. 29775599 PMC6120785 source
- Not checked yetcites [104] Boursi B, Finkelman B, Giantonio BJ, A clinical prediction model to assess risk for pancreatic cancer among patients with pre-diabetes. Jour Clin Onc 2019; 36: e16226. source
- Not checked yetcites [105] Boursi B, Finkelman B, Giantonio BJ, A clinical prediction model to assess risk for pancreatic cancer among patients with new-onset diabetes. Gastroenterology 2017; 152: 840– 50.e3. 27923728 PMC5337138 source
- Not checked yetcites [106] Baecker A, Kim S, Risch HA, Do changes in health reveal the possibility of undiagnosed pancreatic cancer? Development of a risk-prediction model based on healthcare claims data. PLoS One 2019; 14: e0218580. 31237889 PMC6592596 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“EUROPAC has also shown that the age of onset of pancreatic ductal adenocarcinoma becomes progressively earlier with each generation in familial pancreatic cancer,99”
§ Early detection of pancreatic cancer > Ongoing trials and studies for early detection
What the sources say
- Not checked yetcites [99] McFaul CD, Greenhalf W, Earl J, Anticipation in familial pancreatic cancer. Gut 2006; 55: 252– 58. 15972300 PMC1856528 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“The ability to detect precancerous tissue changes in the pancreas using medical imaging among individuals at high risk has also been shown.110,122–125”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Artificial intelligence-assisted CT methods and novel MRI methods
What the sources say
- Not checked yetcites [110] Klein AP, Lindström S, Mendelsohn JB, An absolute risk model to identify individuals at elevated risk for pancreatic cancer in the general population. PLoS One 2013; 8: e72311. 24058443 PMC3772857 source
- Not checked yetcites [122] Canto MI, Goggins M, Yeo CJ, Screening for pancreatic neoplasia in high-risk individuals: an EUS-based approach. Clin Gastroenterol Hepatol 2004; 2: 606– 21. 15224285 source
- Not checked yetcites [123] Canto MI, Goggins M, Hruban RH, Screening for early pancreatic neoplasia in high-risk individuals: a prospective controlled study. Clin Gastroenterol Hepatol 2006; 4: 766– 81, quiz 665. 16682259 source
- Not checked yetcites [124] Poley JW, Kluijt I, Gouma DJ, The yield of first-time endoscopic ultrasonography in screening individuals at a high risk of developing pancreatic cancer. Am J Gastroenterol 2009; 104: 2175– 81. 19491823 source
- Not checked yetcites [125] Verna EC, Hwang C, Stevens PD, Pancreatic cancer screening in a prospective cohort of high-risk patients: a comprehensive strategy of imaging and genetics. Clin Cancer Res 2010; 16: 5028– 37. 20876795 source
plaindirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Reliance on coded diagnoses without laboratory parameters limited the performance of these models.”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on electronic health records
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“weight loss has been validated as one of three key factors to predict early stage disease in patients with new-onset diabetes,103”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Deep learning methodologies applied to abdominal imaging
What the sources say
- Not checked yetcites [103] Sharma A, Kandlakunta H, Nagpal SJS, Model to determine risk of pancreatic cancer in patients with new-onset diabetes. Gastroenterology 2018; 155: 730– 739.e3. 29775599 PMC6120785 source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Among individuals with new-onset diabetes, this model identifies a population with 5% 3-year predicted risk of pancreatic ductal adenocarcinoma, with 11% sensitivity and 99·7% specificity (AUC 0·82).104”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on electronic health records
What the sources say
- Not checked yetcites [104] Boursi B, Finkelman B, Giantonio BJ, A clinical prediction model to assess risk for pancreatic cancer among patients with pre-diabetes. Jour Clin Onc 2019; 36: e16226. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“found that pancreatic ductal adenocarcinoma had the lowest 5-year survival rates among the investigated cancer types, ranging from 7·9% in the UK to 14·6% in Australia.4”
§ Early detection of pancreatic cancer > Summary
What the sources say
- Not checked yetcites [4] Arnold M, Rutherford MJ, Bardot A, Progress in cancer survival, mortality, and incidence in seven high-income countries 1995–2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol 2019; 20: 1493– 505. 31521509 PMC6838671 source
plainn = 9- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The establishment of new tailor-made cohorts (of individuals with new-onset diabetes or with symptoms) provides unique pre-diagnostic resources for biological and epidemiological marker discovery and validation.”
§ Early detection of pancreatic cancer > Summary
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Early diagnosis will undoubtedly play an important role in improving these figures, and, as our review points out, progress has been made.”
§ Early detection of pancreatic cancer > Summary
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“whereas artificial intelligence applied to imaging offers the possibility of detecting earlier lesions.”
§ Early detection of pancreatic cancer > Summary
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Radiomic analysis of medical images using deep learning might allow identification of unique image features in pre-diagnostic images to allow accurate prediction of pancreatic ductal adenocarcinoma in the near future.”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Artificial intelligence-assisted CT methods and novel MRI methods
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Imaging represents more sensitive and specific information for parenchyma and duct of the pancreas than personal health data.”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Artificial intelligence-assisted CT methods and novel MRI methods
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
- Probably not a substantial claim. 20
- It may state two separate claims as one. 32
Some cited sources support this claim and some don’t — read each source’s verdict below.
In the paper
“Guidelines recommend immediate surgical resection for any lesion with high-risk stigmata, and regular surveillance with interval imaging (MRI or endoscopic ultrasound) for all mucinous or indeterminate lesions.21,60”
§ Early detection of pancreatic cancer > Practicalities of screening > How should individuals be screened?
What the sources say
- Disputedcites [21] Vege SS, Ziring B, Jain R, Moayyedi P, Clinical Guidelines Committee, American Gastroenterology Association. American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology 2015; 148: 819– 22; quize12–3. 25805375 sourceExperimental — accuracy not yet measured
In “When Can Pancreatic Cyst Surveillance Be Discontinued?” (page not supplied), the AGA conditionally suggests surgery for specified combinations of concerning features—not immediate resection of any lesion with a high-risk feature. In “Issues Related to the Conduct of Surveillance” (page not supplied), it recommends interval MRI for selected cysts; it also advises stopping surveillance after five unchanged years or when a patient is no longer a surgical candidate. These recommendations contradict the claim’s categorical surgery and surveillance rules. (LLM, conf=0.89)
Checked by a reasoning model — may be wrong.
- Partly supportedcites [60] European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut 2018; 67: 789– 804. 29574408 PMC5890653 sourceExperimental — accuracy not yet measured
The IPMN recommendations (§4.11) identify features that are absolute indications for surgery, while §§4.2 and 5.3 recommend interval follow-up for IPMN and MCN that are not resected. Section 7.2 also recommends surveillance for undefined cysts without malignancy risk factors. The claim overgeneralizes these conditional recommendations: the guidelines do not call for immediate resection of any pancreatic lesion with high-risk features or surveillance of all mucinous and indeterminate lesions. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Disputed
Some cited sources support this claim and some don’t — read each source’s verdict below.
In the paper
“Surveillance protocols vary between the different guidelines, but typically recommend cross-sectional imaging once every 6 months in the first year, and annually thereafter if no changes are detected.”
§ Early detection of pancreatic cancer > Practicalities of screening > How should individuals be screened?
What the sources say
- Disputedcites [21] Vege SS, Ziring B, Jain R, Moayyedi P, Clinical Guidelines Committee, American Gastroenterology Association. American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology 2015; 148: 819– 22; quize12–3. 25805375 sourceExperimental — accuracy not yet measured
In “Issues Related to the Conduct of Surveillance,” recommendation 2 calls for MRI after 1 year and then every 2 years if the cyst remains unchanged—not imaging every 6 months in the first year and annually thereafter. The Summary also describes the AGA’s 2-year interval as less frequent than previously published guidelines; it does not establish the claimed schedule as typical. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
- Supportedcites [60] European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut 2018; 67: 789– 804. 29574408 PMC5890653 source
The Recommendations for IPMN (section 4.2) call for follow-up at 6 months in the first year and yearly thereafter when no surgical risk factors are present. The MCN recommendations (section 5.3) give the same schedule if no changes are observed, and the Radiology recommendations (section 2) prefer MRI for follow-up. The guideline also specifies different schedules for some cysts, consistent with the citing sentence’s qualification that protocols vary. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Disputed
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“However, by combining these factors through cancer decision support tools, the 5% risk threshold can be reached in some individuals, defining a further group suitable for screening.10,12,13”
§ Early detection of pancreatic cancer > Practicalities of screening > Who should be screened?
What the sources say
- Partly supportedcites [10] Keane MG, Horsfall L, Rait G, Pereira SP. A case-control study comparing the incidence of early symptoms in pancreatic and biliary tract cancer. BMJ Open 2014; 4: e005720. PMC4244441 25410605 sourceExperimental — accuracy not yet measured
The Discussion supports developing decision support tools that combine multiple early alarm symptoms and mentions thresholds for investigation. It does not state that combining factors brings some individuals to a 5% risk threshold or defines a group suitable for screening. (LLM, conf=0.85)
- Partly supportedcites [12] Hippisley-Cox J, Coupland C. Identifying patients with suspected pancreatic cancer in primary care: derivation and validation of an algorithm. Br J Gen Pract 2012; 62: e38– 45. 22520674 PMC3252538 sourceExperimental — accuracy not yet measured
Box 1 gives examples in which the algorithm combines risk factors and symptoms to estimate individual pancreatic-cancer risks of 10.2% and 11.3%, above the claimed 5% threshold. But the ‘Individual risk assessment and thresholds’ section proposes further investigation or clinical assessment, not a 5% screening threshold; ‘How this fits in’ says there is no reliable screening test. The claim’s screening-suitability conclusion is therefore not supported by this paper. (LLM, conf=0.85)
- Partly supportedcites [13] Stapley S, Peters TJ, Neal RD, Rose PW, Walter FM, Hamilton W. The risk of pancreatic cancer in symptomatic patients in primary care: a large case-control study using electronic records. Br J Cancer 2012; 106: 1940– 44. 22617126 PMC3388562 sourceExperimental — accuracy not yet measured
The Results (page unavailable) report that some symptom combinations in patients aged 60 or older had pancreatic-cancer predictive values above 10%, supporting the point that combined factors can exceed 5% risk in some patients. But the paper does not establish a 5% screening threshold or show that a cancer decision support tool identifies a group suitable for screening. Its Discussion recommends considering symptomatic patients for further investigation instead. (LLM, conf=0.85)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“However, studies underway in the USA61 and UK62 are actively investigating how best to detect pancreatic ductal adenocarcinoma in individuals with new-onset diabetes.”
§ Early detection of pancreatic cancer > Practicalities of screening > How should individuals be screened?
What the sources say
- Supportedcites [61] Maitra A, Sharma A, Brand RE, A prospective study to establish a new-onset diabetes cohort: from the consortium for the study of chronic pancreatitis, diabetes, and pancreatic cancer. Pancreas 2018; 47: 1244– 48. 30325864 PMC6432934 source
The citation to this paper is attached to the US study, not the separately cited UK study. The Abstract describes a US-initiated new-onset diabetes cohort, and the Specific Aims describe validating biomarkers for occult pancreatic ductal adenocarcinoma and developing an early-detection screening protocol. The copy provides no page numbers for these passages. (LLM, conf=0.90)
- Not matchedcites [62] UK Early Detection Initiative, Liverpool Clinical Trials Centre, Cancer Research UK. UK early detection initiative for pancreatic cancer. www.uk-edi.co.uk (accessed Sept 17, 2019).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
In the paper
“Screening individuals in high-risk groups increases the rate of detection and reduces false-positive results.8”
§ Early detection of pancreatic cancer > Introduction
What the sources say
- Not checked yetcites [8] Poruk KE, Firpo MA, Adler DG, Mulvihill SJ. Screening for pancreatic cancer: why, how, and who? Ann Surg 2013; 257: 17– 26. 22895395 PMC4113008 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Here, we review groups at high risk for pancreatic ductal adenocarcinoma, including individuals with inherited predisposition and patients with pancreatic cystic lesions.”
- Also stated in: § Introduction · plain
“Several groups at high risk of pancreatic ductal adenocarcinoma have been identified, including individuals in families with an inherited risk,17,18 people with cystic lesions of the pancreas,19–21 and people older than 50 years, newly diagnosed with type 2 diabetes.22,23”
§ Early detection of pancreatic cancer > Abstract
What the sources say
- Not checked yetcites [17] Petersen GM. Familial pancreatic adenocarcinoma. Hematol Oncol Clin North Am 2015; 29: 641– 53. 26226902 PMC4522044 source
- Not checked yetcites [18] Canto MI, Almario JA, Schulick RD, Risk of neoplastic progression in individuals at high risk for pancreatic cancer undergoing long-term surveillance. Gastroenterology 2018; 155: 740– 51.e2. 29803839 PMC6120797 source
- Not checked yetcites [19] Kimura W, Moriya T, Hirai I, Multicenter study of serous cystic neoplasm of the Japan pancreas society. Pancreas 2012; 41: 380– 87. 22415666 source
- Not checked yetcites [20] Del Chiaro M, Verbeke C, Salvia R, European experts consensus statement on cystic tumours of the pancreas. Dig Liver Dis 2013; 45: 703– 11. 23415799 source
- Not checked yetcites [21] Vege SS, Ziring B, Jain R, Moayyedi P, Clinical Guidelines Committee, American Gastroenterology Association. American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology 2015; 148: 819– 22; quize12–3. 25805375 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Introduction · plain
In the paper
“Pancreatic ductal adenocarcinoma is most frequently detected at an advanced stage. Such late detection restricts treatment options and contributes to a dismal 5-year survival rate of 3–15%.”
- Also stated in: § Introduction · plain
“These dismal figures are attributed to late-stage and incurable-stage diagnosis as well as high tumour chemoresistance.5”
§ Early detection of pancreatic cancer > Abstract
What the sources say
- Not checked yetcites [5] Kamisawa T, Wood LD, Itoi T, Takaori K. Pancreatic cancer. Lancet 2016; 388: 73– 85. 26830752 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Introduction · plain
In the paper
“Pancreatic ductal adenocarcinoma is relatively uncommon and screening of the asymptomatic adult population is not feasible or recommended with current modalities.”
- Also stated in: § Introduction · plain
“The low disease prevalence makes screening of the asymptomatic adult population unfeasible. Existing diagnostic methods would incur unacceptably high rates of false-positive findings,16”
§ Early detection of pancreatic cancer > Abstract
What the sources say
- Not checked yetcites [16] Hart PA, Chari ST. Is screening for pancreatic cancer in high-risk individuals one step closer or a fool’s errand? Clin Gastroenterol Hepatol 2019; 17: 36– 38. 30268560 PMC6557281 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Introduction · plain
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, screening of individuals in high-risk groups is recommended.”
§ Early detection of pancreatic cancer > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
In the paper
“There is increasing knowledge about the progression of intraductal papillary mucinous neoplasms from a genetic perspective, which suggests that early lesions are heterogeneous, whereas lesions with high-grade dysplasia have a smaller number of homogeneous driver genes.42”
§ Early detection of pancreatic cancer > High-risk groups > Cystic lesions
What the sources say
- Not checked yetcites [42] Fischer CG, Beleva Guthrie V, Braxton AM, Intraductal papillary mucinous neoplasms arise from multiple independent clones, each with distinct mutations. Gastroenterology 2019; 157: 1123– 37.e22. 31175866 PMC6756950
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“familial pancreatic cancer is a syndrome that is defined as having multiple first-degree relatives with pancreatic ductal adenocarcinoma, exclusive of other cancer syndromes.36”
§ Early detection of pancreatic cancer > High-risk groups > Familial or inherited risk
What the sources say
- Not checked yetcites [36] Grocock CJ, Vitone LJ, Harcus MJ, Neoptolemos JP, Raraty MG, Greenhalf W. Familial pancreatic cancer: a review and latest advances. Adv Med Sci 2007; 52: 37– 49. 18217388
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“It is estimated that a cyst seen incidentally on MRI has a 10 in 100 000 chance of being a mucinous invasive malignancy, and a 17 in 100 000 chance of being a ductal cancer.21”
§ Early detection of pancreatic cancer > High-risk groups > Cystic lesions
What the sources say
- Not checked yetcites [21] Vege SS, Ziring B, Jain R, Moayyedi P, Clinical Guidelines Committee, American Gastroenterology Association. American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology 2015; 148: 819– 22; quize12–3. 25805375 source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Some families affected by BRCA2 mutations have an increased incidence of pancreatic ductal adenocarcinoma and breast or ovarian cancer. These families are classified as having both HBOC and hereditary pancreatic cancer.33”
§ Early detection of pancreatic cancer > High-risk groups > Familial or inherited risk
What the sources say
- Not checked yetcites [33] Iqbal J, Ragone A, Lubinski J, The incidence of pancreatic cancer in BRCA1 and BRCA2 mutation carriers. Br J Cancer 2012; 107: 2005– 09. 23099806 PMC3516682 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the absence of autosomal dominance, risk for an individual might be high, but such a risk is difficult or impossible to prospectively predict.”
§ Early detection of pancreatic cancer > High-risk groups > Familial or inherited risk
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A study of 862 individuals undergoing surgery for pancreatic cysts found that a combined molecular and clinical marker panel was more accurate than current clinical features alone for classifying patients who required surgery, or routine monitoring, or did not require surveillance; use of these combined markers would have decreased the number of unnecessary operations by 60% compared with the use”
§ Early detection of pancreatic cancer > High-risk groups > Cystic lesions
What the sources say
- Not checked yetcites [41] Springer S, Masica DL, Dal Molin M, A multimodality test to guide the management of patients with a pancreatic cyst. Sci Transl Med 2019; 11: eaav4772. 31316009 PMC7859881 source
hedgeddirectn = 862- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“with an incidence of 8–12 per 100 000 per year and a 1·3% lifetime risk of developing the disease.3”
§ Early detection of pancreatic cancer > Introduction
What the sources say
- Not checked yetcites [3] Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394– 424. 30207593
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“This target includes individuals with at least two first-degree relatives with pancreatic ductal adenocarcinoma, patients with hereditary pancreatitis or particular genetic syndromes (eg, Peutz-Jeghers syndrome, or germline mutations in the CDKN2A, BRCA2, or PALB2),6,54 and individuals with mucinous cystic lesions of the pancreas.19–21”
§ Early detection of pancreatic cancer > Practicalities of screening > Who should be screened?
What the sources say
- Not checked yetcites [6] Canto MI, Harinck F, Hruban RH, International Cancer of the Pancreas Screening (CAPS) Consortium summit on the management of patients with increased risk for familial pancreatic cancer. Gut 2013; 62: 339– 47. 23135763 PMC3585492 source
- Not checked yetcites [54] Kenner BJ, Chari ST, Cleeter DF, Go VL. Early detection of sporadic pancreatic cancer: strategic map for innovation—a white paper. Pancreas 2015; 44: 686– 92. 25938853 PMC4467583 source
- Not checked yetcites [19] Kimura W, Moriya T, Hirai I, Multicenter study of serous cystic neoplasm of the Japan pancreas society. Pancreas 2012; 41: 380– 87. 22415666 source
- Not checked yetcites [20] Del Chiaro M, Verbeke C, Salvia R, European experts consensus statement on cystic tumours of the pancreas. Dig Liver Dis 2013; 45: 703– 11. 23415799 source
- Not checked yetcites [21] Vege SS, Ziring B, Jain R, Moayyedi P, Clinical Guidelines Committee, American Gastroenterology Association. American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology 2015; 148: 819– 22; quize12–3. 25805375 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“However, international guidelines and a white paper on the early detection of pancreatic ductal adenocarcinoma recommend targeted screening of individuals whose lifetime risk of developing pancreatic ductal adenocarcinoma is higher than 5% (figure 1).6,54”
§ Early detection of pancreatic cancer > Practicalities of screening > Who should be screened?
What the sources say
- Not checked yetcites [6] Canto MI, Harinck F, Hruban RH, International Cancer of the Pancreas Screening (CAPS) Consortium summit on the management of patients with increased risk for familial pancreatic cancer. Gut 2013; 62: 339– 47. 23135763 PMC3585492 source
- Not checked yetcites [54] Kenner BJ, Chari ST, Cleeter DF, Go VL. Early detection of sporadic pancreatic cancer: strategic map for innovation—a white paper. Pancreas 2015; 44: 686– 92. 25938853 PMC4467583 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Other high-risk groups have been identified, such as individuals with new-onset diabetes (as discussed above), modifiable risk factors (eg, smoking, obesity), non-modifiable risk factors (eg, age), specific comorbidities (eg, obesity, chronic pancreatitis), or early symptoms (some of which are present for more than 1 year before diagnosis).10,12,13,56”
§ Early detection of pancreatic cancer > Practicalities of screening > Who should be screened?
What the sources say
- Not checked yetcites [10] Keane MG, Horsfall L, Rait G, Pereira SP. A case-control study comparing the incidence of early symptoms in pancreatic and biliary tract cancer. BMJ Open 2014; 4: e005720. PMC4244441 25410605 source
- Not checked yetcites [12] Hippisley-Cox J, Coupland C. Identifying patients with suspected pancreatic cancer in primary care: derivation and validation of an algorithm. Br J Gen Pract 2012; 62: e38– 45. 22520674 PMC3252538 source
- Not checked yetcites [13] Stapley S, Peters TJ, Neal RD, Rose PW, Walter FM, Hamilton W. The risk of pancreatic cancer in symptomatic patients in primary care: a large case-control study using electronic records. Br J Cancer 2012; 106: 1940– 44. 22617126 PMC3388562 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The US Preventive Services Task Force and other guidelines recommend against screening for pancreatic ductal adenocarcinoma in asymptomatic adults at average risk.6,53,54”
§ Early detection of pancreatic cancer > Practicalities of screening > Who should be screened?
What the sources say
- Not checked yetcites [6] Canto MI, Harinck F, Hruban RH, International Cancer of the Pancreas Screening (CAPS) Consortium summit on the management of patients with increased risk for familial pancreatic cancer. Gut 2013; 62: 339– 47. 23135763 PMC3585492 source
- Not checked yetcites [53] Owens DK, Davidson KW, Krist AH, Screening for pancreatic cancer: US Preventive Services Task Force Reaffirmation Recommendation Statement. JAMA 2019; 322: 438– 44. 31386141 source
- Not checked yetcites [54] Kenner BJ, Chari ST, Cleeter DF, Go VL. Early detection of sporadic pancreatic cancer: strategic map for innovation—a white paper. Pancreas 2015; 44: 686– 92. 25938853 PMC4467583 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Established screening programmes exist, including the pan-European EUROPAC registry,36 North American National Familial Pancreatic Tumor Registry,57 and the German National Case Collection for familial pancreatic cancer.58”
§ Early detection of pancreatic cancer > Practicalities of screening > How should individuals be screened?
What the sources say
- Not checked yetcites [36] Grocock CJ, Vitone LJ, Harcus MJ, Neoptolemos JP, Raraty MG, Greenhalf W. Familial pancreatic cancer: a review and latest advances. Adv Med Sci 2007; 52: 37– 49. 18217388
- Not checked yetcites [57] Hruban RH, Petersen GM, Goggins M, Familial pancreatic cancer. Ann Oncol 1999; 10 (suppl 4): 69– 73. 10436789 source
- Not checked yetcites [58] Schneider R, Slater EP, Sina M, German national case collection for familial pancreatic cancer (FaPaCa): ten years experience. Fam Cancer 2011; 10: 323– 30. 21207249 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Approximately 8% of all pancreatic ductal adenocarcinomas are believed to arise from premalignant mucinous cystic lesions of the pancreas.59”
§ Early detection of pancreatic cancer > Practicalities of screening > How should individuals be screened?
What the sources say
- Not checked yetcites [59] Le H, Ziogas A, Rhee JM, Lee JG, Lipkin SM, Zell JA. A population-based, descriptive analysis of malignant intraductal papillary mucinous neoplasms of the pancreas. Cancer Epidemiol Biomarkers Prev 2008; 17: 2737– 41. 18843017 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The diabetes experienced by most patients with pancreatic ductal adenocarcinoma is of recent onset (diagnosed less than 24–36 months before diagnosis of pancreatic ductal adenocarcinoma), and is improved by surgical resection of the tumour.48”
§ Early detection of pancreatic cancer > High-risk groups > New-onset diabetes mellitus
What the sources say
- Not checked yetcites [48] Hart PA, Bellin MD, Andersen DK, Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. Lancet Gastroenterol Hepatol 2016; 1: 226– 37. 28404095 PMC5495015 source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Screening of the general population carries risk, and there is currently no evidence that it reduces mortality or is cost-effective.54,55”
§ Early detection of pancreatic cancer > Practicalities of screening > Who should be screened?
What the sources say
- Not checked yetcites [54] Kenner BJ, Chari ST, Cleeter DF, Go VL. Early detection of sporadic pancreatic cancer: strategic map for innovation—a white paper. Pancreas 2015; 44: 686– 92. 25938853 PMC4467583 source
- Not checked yetcites [55] Henrikson NB, Aiello Bowles EJ, Blasi PR, Screening for pancreatic cancer: updated evidence report and systematic review for the US preventive services task force. JAMA 2019; 322: 445– 54. 31386140 PMC13387050 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“This study, which was done within the Swedish health-care system, concluded that biomarker-mediated screening is highly desirable.”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Challenges and opportunities
What the sources say
- Not checked yetcites [74] Ghatnekar O, Andersson R, Svensson M, Modelling the benefits of early diagnosis of pancreatic cancer using a biomarker signature. Int J Cancer 2013; 133: 2392– 97. 23649606 source
boosted- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Although patients often show symptoms that suggest pancreatic ductal adenocarcinoma at repeated primary care consultations before diagnosis,12,13,63 they often encounter delays in the workup process.64”
§ Early detection of pancreatic cancer > Practicalities of screening > How should individuals be screened?
What the sources say
- Not checked yetcites [12] Hippisley-Cox J, Coupland C. Identifying patients with suspected pancreatic cancer in primary care: derivation and validation of an algorithm. Br J Gen Pract 2012; 62: e38– 45. 22520674 PMC3252538 source
- Not checked yetcites [13] Stapley S, Peters TJ, Neal RD, Rose PW, Walter FM, Hamilton W. The risk of pancreatic cancer in symptomatic patients in primary care: a large case-control study using electronic records. Br J Cancer 2012; 106: 1940– 44. 22617126 PMC3388562 source
- Not checked yetcites [63] Lyratzopoulos G, Neal RD, Barbiere JM, Rubin GP, Abel GA. Variation in number of general practitioner consultations before hospital referral for cancer: findings from the 2010 National Cancer Patient Experience Survey in England. Lancet Oncol 2012; 13: 353– 65. 22365494 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“In 2013, cancer decision support tools were incorporated into software systems of general practitioner practices in the UK.12”
§ Early detection of pancreatic cancer > Practicalities of screening > How should individuals be screened?
What the sources say
- Not checked yetcites [12] Hippisley-Cox J, Coupland C. Identifying patients with suspected pancreatic cancer in primary care: derivation and validation of an algorithm. Br J Gen Pract 2012; 62: e38– 45. 22520674 PMC3252538 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Biomarkers could play an important role in early detection of pancreatic ductal adenocarcinoma by enriching for individuals in high-risk groups who have the highest chance of a cancer diagnosis, thereby helping clinicians prioritise individuals for screening (figure 2).”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Challenges and opportunities
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Because signals from normal tissues are reduced or eliminated, the signals can be engineered to be highly specific for cancer, and the method can be tailored for highly sensitive detection tools.”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Synthetic biomarkers
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“More frequent surveillance is advocated for larger lesions or lesions with worrisome features.21,60”
§ Early detection of pancreatic cancer > Practicalities of screening > How should individuals be screened?
What the sources say
- Not checked yetcites [21] Vege SS, Ziring B, Jain R, Moayyedi P, Clinical Guidelines Committee, American Gastroenterology Association. American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology 2015; 148: 819– 22; quize12–3. 25805375 source
- Not checked yetcites [60] European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut 2018; 67: 789– 804. 29574408 PMC5890653 source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Moreover, the use of high-risk groups as controls and combining molecular markers with clinical features is an important consideration when identifying biomarkers capable of selecting populations at highest risk of development of pancreatic ductal adenocarcinoma for screening.75”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Current promising biomarkers for early detection
What the sources say
- Not checked yetcites [75] Springer S, Wang Y, Dal Molin M, A combination of molecular markers and clinical features improve the classification of pancreatic cysts. Gastroenterology 2015; 149: 1501– 10. 26253305 PMC4782782 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Research into the molecular changes occurring during the sequential progression from lesion, through early-stage pancreatic ductal adenocarcinoma, and finally to advanced disease is generating a greater understanding of development and progression of pancreatic ductal adenocarcinoma. This understanding is providing a basis for designing rational strategies to develop biomarkers for early detection”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Current promising biomarkers for early detection
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Consequently, single biomarkers will probably not have high sensitivity for detection of pancreatic ductal adenocarcinoma, and robust panels of biomarkers will be required.”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Challenges and opportunities
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The usefulness and outcomes of the current programme are subject to ongoing assessment via the Accelerate, Coordinate, Evaluate Programme, an initiative supported by Cancer Research UK and Macmillan Cancer Support.65”
§ Early detection of pancreatic cancer > Practicalities of screening > How should individuals be screened?
What the sources say
- Not matchedcites [65] Cancer Research UK. Accelerate, Coordinate, Evaluate (ACE) programme. 2019 https://www.cancerresearchuk.org/health-professional/diagnosis/accelerate-coordinate-evaluate-ace-programme/multidisciplinary-diagnostic-centres-mdcs (accessed Sept 2, 2019).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“Although large population-based cohorts that have recruited healthy individuals (such as UKCTOCS72 and EPIC73) contain patient samples that precede diagnosis of pancreatic ductal adenocarcinoma, crucial information—such as family history and comorbidity data, including the presence of chronic pancreatitis or diabetes—are not consistently available.”
§ Early detection of pancreatic cancer > Role for biomarkers in early detection of pancreatic ductal adenocarcinoma > Challenges and opportunities
What the sources say
- Not checked yetcites [72] Menon U, Gentry-Maharaj A, Ryan A, Recruitment to multicentre trials—lessons from UKCTOCS: descriptive study. BMJ 2008; 337: a2079. 19008269 PMC2583394 source
- Not checked yetcites [73] Riboli E, Hunt KJ, Slimani N, European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection. Public Health Nutr 2002; 5: 1113– 24. 12639222 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“A small pilot study suggested that pancreatic ductal adenocarcinoma-associated diabetes might be distinguished from the more prevalent type 2 diabetes by a blunted pancreatic polypeptide response to a mixed meal.94”
§ Early detection of pancreatic cancer > Ongoing trials and studies for early detection
What the sources say
- Not checked yetcites [94] Hart PA, Baichoo E, Bi Y, Hinton A, Kudva YC, Chari ST. Pancreatic polypeptide response to a mixed meal is blunted in pancreatic head cancer associated with diabetes mellitus. Pancreatology 2015; 15: 162– 66. 25766398 source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“This model reached an AUC of 0·85 and incorporated data on age, sex, race and ethnicity, diabetes, emphysema, asthma, stroke, cardiovascular diseases, ulcers, other cancer, hypertension, smoking status, physical activity, alcohol consumption, and family history of pancreatic ductal adenocarcinoma.”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on research data
What the sources say
- Not checked yetcites [109] Muhammad W, Hart GR, Nartowt B, Pancreatic cancer prediction through an artificial neural network. Front Artif Intell 2019; 2: 2. PMC7861334 33733091 source
- Not checked yetcites [110] Klein AP, Lindström S, Mendelsohn JB, An absolute risk model to identify individuals at elevated risk for pancreatic cancer in the general population. PLoS One 2013; 8: e72311. 24058443 PMC3772857 source
- Not checked yetcites [111] Risch HA, Yu H, Lu L, Kidd MS. Detectable symptomatology preceding the diagnosis of pancreatic cancer and absolute risk of pancreatic cancer diagnosis. Am J Epidemiol 2015; 182: 26– 34. 26049860 PMC4479115 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Other models based on research interviews have not reached similar levels of performance, but have consistently shown that age, sex, smoking, diabetes, family history of pancreatic ductal adenocarcinoma, abdominal symptoms, and blood group point to an increased risk of pancreatic ductal adenocarcinoma.”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on research data
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Indeed, sarcopenia and fat loss are known to be part of a wasting syndrome of pancreatic ductal adenocarcinoma and might have prognostic implications.117,118”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Deep learning methodologies applied to abdominal imaging
What the sources say
- Not checked yetcites [117] Ozola Zalite I, Zykus R, Francisco Gonzalez M, Influence of cachexia and sarcopenia on survival in pancreatic ductal adenocarcinoma: a systematic review. Pancreatology 2015; 15: 19– 24. 25524484 source
- Not checked yetcites [118] Peng P, Hyder O, Firoozmand A, Impact of sarcopenia on outcomes following resection of pancreatic adenocarcinoma. J Gastrointest Surg 2012; 16: 1478– 86. 22692586 PMC3578313 source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A consistent performance characteristic of electronic health record models is high specificity and low sensitivity, leading to high false-negative rates.”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on electronic health records
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Further models based on insurance claims have been developed, with poor diagnostic performance (AUC 0·73).106,107”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on electronic health records
What the sources say
- Not checked yetcites [106] Baecker A, Kim S, Risch HA, Do changes in health reveal the possibility of undiagnosed pancreatic cancer? Development of a risk-prediction model based on healthcare claims data. PLoS One 2019; 14: e0218580. 31237889 PMC6592596 source
- Not checked yetcites [107] Hsieh MH, Sun LM, Lin CL, Hsieh MJ, Hsu CY, Kao CH. Development of a prediction model for pancreatic cancer in patients with type 2 diabetes using logistic regression and artificial neural network models. Cancer Manag Res 2018; 10: 6317– 24. 30568493 PMC6267763 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The same model applied to individuals with pre-diabetes showed lower accuracy (AUC 0·71), but consistent direction of association with pancreatic ductal adenocarcinoma.105”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on electronic health records
What the sources say
- Not checked yetcites [105] Boursi B, Finkelman B, Giantonio BJ, A clinical prediction model to assess risk for pancreatic cancer among patients with new-onset diabetes. Gastroenterology 2017; 152: 840– 50.e3. 27923728 PMC5337138 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The non-invasive measurement of different body compartments has already been fully automated and applied to pancreatic ductal adenocarcinoma through artificial intelligence methodologies, and this application could be easily incorporated into the evaluation of routine diagnostic imaging.119”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Deep learning methodologies applied to abdominal imaging
What the sources say
- Not checked yetcites [119] Bridge CP, Rosenthal M, Wright B, Fully-automated analysis of body composition from CT in cancer patients using convolutional neural networks. International workshop on skin image analysis; 10 2, 2018. source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“This model performed as well (AUC=0·81) as the UK model,105 but had low positive predictive value (0·3–0·4% risk over 10 years) because it was evaluated in the general unselected population aged 40 years and older.108”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on electronic health records
What the sources say
- Not checked yetcites [108] Yu A, Woo SM, Joo J, Development and validation of a prediction model to estimate individual risk of pancreatic cancer. PLoS One 2016; 11: e0146473. 26752291 PMC4708985 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“With respect to mucinous cysts, identifying the few individuals with mucinous cystic lesions at the highest risk of progression to pancreatic ductal adenocarcinoma is still a key knowledge gap.”
§ Early detection of pancreatic cancer > Summary
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Careful and ethical use of existing data—whether through social media or electronic health records—has the power to facilitate prediction models, whereas artificial intelligence applied to imaging offers the possibility of detecting earlier lesions.”
§ Early detection of pancreatic cancer > Summary
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Advances in early detection will go together with improvements in treatment to extend survival for people with pancreatic ductal adenocarcinoma.”
§ Early detection of pancreatic cancer > Summary
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
In the paper
“Muhammad and colleagues used artificial intelligence to analyse available personal health data to calculate risk for pancreatic ductal adenocarcinoma in the general population and to identify high-risk individuals.109”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Artificial intelligence-assisted CT methods and novel MRI methods
What the sources say
- Not checked yetcites [109] Muhammad W, Hart GR, Nartowt B, Pancreatic cancer prediction through an artificial neural network. Front Artif Intell 2019; 2: 2. PMC7861334 33733091 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Roffman and colleagues127 used artificial intelligence to predict non-melanoma skin cancer by using personal health data (eg, sex, race, Hispanic ethnicity, hypertension, heart disease, exercise habits, history of stroke) commonly available in electronic medical record systems.”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Artificial intelligence-assisted CT methods and novel MRI methods
What the sources say
- Not checked yetcites [127] Roffman D, Hart G, Girardi M, Ko CJ, Deng J. Predicting non-melanoma skin cancer via a multi-parameterized artificial neural network. Sci Rep 2018; 8: 1701. 29374196 PMC5786038
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
In some cases, the definitive diagnosis of pancreatic ductal adenocarcinoma is only possible after surgery, when sufficient tumour material is available for histological diagnosis.
“In some cases, the definitive diagnosis of pancreatic ductal adenocarcinoma is only possible following surgery (when there is sufficient tumour material to make the histological diagnosis), which carries the risk of substantial morbidity and mortality.”
The paper relies on this without support.
Some hereditary cancer syndromes, including HBOC, Lynch syndrome 2, FAMMM, Peutz-Jegher’s syndrome, and Li-Fraumeni syndrome, are associated with pancreatic ductal adenocarcinoma.
“Some hereditary cancer syndromes—including hereditary breast-ovarian cancer syndrome (HBOC), Lynch syndrome 2, familial atypical multiple mole melanoma (FAMMM), Peutz-Jegher’s syndrome, and Li-Fraumeni syndrome—are associated with pancreatic ductal adenocarcinoma.”
The paper relies on this without support.
Not all pancreatic cystic lesions are intraductal papillary mucinous neoplasms or mucinous cystic neoplasms; many have no risk of malignant transformation and do not require surveillance.
“First, not all pancreatic cystic lesions are intraductal papillary mucinous neoplasms and mucinous cystic neoplasms. Many are cystic lesions with no risk of malignant transformation and thus do not require surveillance.”
The paper relies on this without support.
Most intraductal papillary mucinous neoplasms and mucinous cystic neoplasms do not progress to pancreatic ductal adenocarcinoma.
“Second, most intraductal papillary mucinous neoplasms and mucinous cystic neoplasms do not progress to pancreatic ductal adenocarcinoma.”
The paper relies on this without support.
Currently available clinical tools are imperfect at differentiating benign pancreatic cysts that are safe to discharge, mucinous cystic lesions that harbour high-grade dysplasia or pancreatic ductal adenocarcinoma and require surgical resection, and mucinous cystic lesions with low-grade dysplasia that are safe to watch.
“Currently available clinical tools are imperfect at differentiating between benign cysts that are safe to discharge, mucinous cystic lesions that harbour high-grade dysplasia or pancreatic ductal adenocarcinoma and require surgical resection, and mucinous cystic lesions that have low-grade dysplasia and are safe to watch.”
The paper relies on this without support.
Different types of pancreatic cysts have specific mutational profiles that can be used to identify the type of cyst with a high level of confidence.
“We now know that different types of pancreatic cysts have specific mutational profiles that can be used to identify the type of cysts with a high level of confidence.”
The paper relies on this without support.
People with long-standing type 2 diabetes of more than 5 years have a 1–1.5-fold increased risk of pancreatic ductal adenocarcinoma compared with the general population.
“People with long-standing type 2 diabetes (more than 5 years) have a 1–1·5-fold increased risk of pancreatic ductal adenocarcinoma compared with the general population.”
The paper relies on this without support.
Individuals with new-onset diabetes are the highest risk group for sporadic pancreatic ductal adenocarcinoma.
“and individuals with new-onset diabetes are the highest risk group for sporadic pancreatic ductal adenocarcinoma.”
The paper relies on this without support.
Approximately 0.8–1% of individuals aged over 50 years with new-onset diabetes have diabetes secondary to pancreatic ductal adenocarcinoma.
“Approximately 0·8–1% of individuals aged over 50 years with new-onset diabetes have diabetes secondary to pancreatic ductal adenocarcinoma.”
The paper relies on this without support.
For newly identified high-risk groups such as patients with new-onset diabetes, there are no established guidelines or screening programmes.
“For the newly identified high-risk groups (such as patients with new-onset diabetes), there are no established guidelines or screening programmes.”
The paper relies on this without support.
Despite thousands of published papers, no single candidate biomarker has translated to clinical use for the early detection of pancreatic ductal adenocarcinoma.
“However, despite thousands of published papers, no single candidate biomarker has translated to clinical use for the early detection of pancreatic ductal adenocarcinoma.”
The paper relies on this without support.
The low incidence of pancreatic ductal adenocarcinoma makes acquiring the quantity of samples necessary for biomarker development difficult, requiring large national and international collaborations.
“The low incidence of pancreatic ductal adenocarcinoma means that acquiring the quantity of samples necessary for biomarker development is not easy, and large national and international collaborations are required.”
The paper relies on this without support.
Currently, biomarker studies do not account well for the finding that a high proportion of patients with pancreatic ductal adenocarcinoma have diabetes, so emerging biomarkers could have an association with diabetes rather than with pancreatic ductal adenocarcinoma.
“Currently, biomarker studies do not account well for the finding that a high proportion of patients with pancreatic ductal adenocarcinoma have diabetes;50 thus, emerging biomarkers could have an association with diabetes rather than with pancreatic ductal adenocarcinoma.”
The paper relies on this without support.
A pronounced deficit in early detection studies for pancreatic ductal adenocarcinoma has been the absence of bespoke pre-diagnostic cohorts.
“Finally, a pronounced deficit in early detection studies for pancreatic ductal adenocarcinoma has been the absence of bespoke pre-diagnostic cohorts.”
The paper relies on this without support.
No biomarkers are currently validated for early detection of pancreatic ductal adenocarcinoma.
“Currently, there are no biomarkers validated for early detection of pancreatic ductal adenocarcinoma.”
The paper relies on this without support.
CA19-9 is elevated in benign and malignant diseases other than pancreatic ductal adenocarcinoma.
“and the marker is increased in other benign and malignant diseases.”
The paper relies on this without support.
CA19-9 is not expressed in people with a Lewis-negative genotype.
“CA19–9 is not expressed in individuals with a Lewis-negative genotype”
The paper relies on this without support.
Onset of diabetes after age 50 is the best available clinical marker for early detection of pancreatic ductal adenocarcinoma.
“Onset of diabetes after age 50 was chosen as the best clinical marker available for early detection of pancreatic ductal adenocarcinoma”
The paper relies on this without support.
Patients with pancreatic ductal adenocarcinoma first experience subtle, vague symptoms that can precede diagnosis by years.
“Because patients with pancreatic ductal adenocarcinoma first experience subtle, vague symptoms that can precede the diagnosis by years”
The paper relies on this without support.
Visual assessment by imaging physicians is qualitative, subjective, and prone to errors and intra-observer and inter-observer variability.
“However, visual assessment by imaging physicians is qualitative, subjective, and prone to errors and intra-observer and inter-observer variabilities.”
The paper relies on this without support.
Many distinguishing features of medical images are hidden from human observers.
“More importantly, many distinguishing features of images are hidden from human observers.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“However, the current PC biomarkers lack sufficient sensitivity and specificity for clinical application 44,161,170.”
From Artificial intelligence in pancreatic cancer (2022) · cites this paper as [44]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Of note, the literature addresses the fact that disease controls such as chronic pancreatitis are needed in studies as there are several examples of biomarkers present in both chronic pancreatitis and PDAC.178”
From Artificial Intelligence and Early Detection of Pancreatic Cancer: 2020 Summative Review (2021) · cites this paper as [178]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“For example, chronic pancreatitis especially those who develop diabetes with chronic pancreatitis have the highest proportional risk of developing PDAC.178,179”
From Artificial Intelligence and Early Detection of Pancreatic Cancer: 2020 Summative Review (2021) · cites this paper as [178]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Another risk population are those patients who are increasingly identified with pancreatic cysts.178”
From Artificial Intelligence and Early Detection of Pancreatic Cancer: 2020 Summative Review (2021) · cites this paper as [178]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“These prediagnostic CT images provide critical morphological information associated with biological changes at the pre-cancer or early cancer stage, which can be extracted using AI and ML methods to predict PDAC.178”
From Artificial Intelligence and Early Detection of Pancreatic Cancer: 2020 Summative Review (2021) · cites this paper as [178]
Experimental — accuracy not yet measured
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Of note, several studies show that the probability PDAC development can be further increased by including additional factors such as weight change, ethnicity, and lifestyle factors that are commonly contained in electronic medical records.171–178”
From Artificial Intelligence and Early Detection of Pancreatic Cancer: 2020 Summative Review (2021) · cites this paper as [178]
Experimental — accuracy not yet measuredIn the citing paper
“a multitude of circulating tumor-derived analytes (proteins, autoantibodies, metabolites, DNA, non-coding RNAs and extracellular vesicles, among others) have been assessed in the context of PDAC early detection39–41.”
From Pancreatic cancer: Advances and challenges (2023) · cites this paper as [41]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on electronic health records
“A consistent performance characteristic of electronic health record models is high specificity and low sensitivity, leading to high false-negative rates.”
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on electronic health records
“A model based on patients with new-onset diabetes residing in Minnesota, USA, incorporated age at onset of diabetes and changes in weight and blood glucose to identify people with a 4·5% 3-year predicted risk of developing pancreatic ductal adenocarcinoma, with 78% sensitivity and 80% specificity (AUC 0·87).103”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Early detection of pancreatic cancer > Advances in artificial intelligence and deep learning methodologies in relation to early detection > Models based on electronic health records
“Among individuals with new-onset diabetes, this model identifies a population with 5% 3-year predicted risk of pancreatic ductal adenocarcinoma, with 11% sensitivity and 99·7% specificity (AUC 0·82).104 The same model applied to individuals with pre-diabetes showed lower accuracy (AUC 0·71), but consistent direction of association with pancreatic ductal adenocarcinoma.105”
§ Early detection of pancreatic cancer > References
“104. Boursi B, Finkelman B, Giantonio BJ, A clinical prediction model to assess risk for pancreatic cancer among patients with pre-diabetes. Jour Clin Onc 2019; 36: e16226. 105. Boursi B, Finkelman B, Giantonio BJ, A clinical prediction model to assess risk for pancreatic cancer among patients with new-onset diabetes.”
Citations
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Self-citationDistant metastasis occurs late during the genetic evolution of pancreatic cancer
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Cited by
Sorted by citations
Mizrahi, J. D., Surana, R., Valle, J. W., & Shroff, R. T. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30974-0 · Cited by 2,559
Pancreatic cancer: Advances and challenges
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Pancreatic cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up
Conroy, T., Pfeiffer, P., Vilgrain, V., Lamarca, Á., Seufferlein, T. T. W., O'Reilly, E. M., Hackert, T., Golan, T., Prager, G. W., Haustermans, K. M., et al. (2023) · Annals of Oncology · doi:10.1016/j.annonc.2023.08.009 · Cited by 706
Proteogenomic characterization of pancreatic ductal adenocarcinoma
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Metadata
- Authors
- Pereira, S. P., Oldfield, L., Ney, A., Hart, P. A., Keane, M. G., Pandol, S. J., Li, D., Greenhalf, W., Jeon, C. Y., Koay, E. J., Almario, C. V., Halloran, C., Lennon, A. M., & Costello, E.
- Affiliations
- University College London (GB)
- University of Liverpool (GB)
- The Ohio State University Wexner Medical Center (US)
- Johns Hopkins University (US)
- Cedars-Sinai Medical Center (US)
- The University of Texas MD Anderson Cancer Center (US)
- Corresponding author
- Costello, Eithne
- ORCID
- Venue
- The Lancet Gastroenterology & Hepatology
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 5
- Issue
- 7
- Pages
- 698-710
- ISSN
- 2468-1156 (ISSN-L)
- 2468-1253
- PMC
- PMC7380506
- OpenAlex
- W2304258614
- Semantic Scholar
- dbdbc71bbd1a6d8362bfb5f28c2ceb4a79e97871
- Cited by
- 482
- References
- 127
- Citations by year
- 2026: 47 · 2025: 76 · 2024: 88 · 2023: 89 · 2022: 99 · 2021: 61 · 2020: 22
- FWCI
- 7.28
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Lancet. Gastroenterology & hepatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Center for Advancing Translational Sciences (U01CA196403–01, 1R01CA218004–01A1, 1U01CA200468–01, UL1TR001881–01, U54CA210181–01)
- Royal College of Surgeons of Edinburgh
- Pancreatic Cancer Action
- Cancer Research UK (C52547/A28210, C7690/A26881)
- National Institute of Diabetes and Digestive and Kidney Diseases (U01DK108327, R01CA230442, U01DK108314, R21CA220073)
- National Institutes of Health (P50-CA062924)
- National Cancer Institute
- Pancreatic Cancer Research Fund
- Pancreatic Cancer UK
- National Institute for Health Research
- National Pancreas Foundation
- Pancreatic Cancer Action Network
- Lustgarten Foundation
- Atlanta Clinical and Translational Science Institute
- Department of Health, Australian Government
- North West Cancer Research Fund
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- pancreatic ductal adenocarcinoma, early detection, high-risk groups, genetic susceptibility, pancreatic cysts, new-onset diabetes, early diagnosis biomarkers, social media, prediction model, electronic health records, artificial intelligence, diagnostic imaging
- MeSH terms
- Deep Learning, Adult, Aged, Aged, 80 and over, Artificial Intelligence, Diabetes Mellitus, Type 2, Diagnostic Imaging, Female, Humans, Male, Mass Screening, Middle Aged, Pancreatic Cyst, Pancreatic Neoplasms, Risk Factors, Biomarkers, Tumor, Genetic Predisposition to Disease, Carcinoma, Pancreatic Ductal, Early Detection of Cancer, Electronic Health Records, Social Media
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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