Cited by 255Pancreatic and Hepatic Oncology ResearchPancreatitis Pathology and TreatmentGlobal Cancer Incidence and Screening

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Screening for Pancreatic Cancer: Why, How, and Who?

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Poruk, Katherine E., Firpo, Matthew A., Adler, Douglas G., Mulvihill, Sean J.·2013·Annals of Surgery

DOI 10.1097/sla.0b013e31825ffbfbPMC PMC4113008

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Abstract

In Brief Pancreatic cancer is the fourth most common cause of cancer mortality in the United States, with 5-year survival rates for patients with resectable tumors ranging from 15% to 20%. However, most patients presenting with distant metastases, are not resectable, and have a 5-year survival rate of close to 0%. This demonstrates a need for improved screening to identify pancreatic cancer while the tumor is still localized and amenable to surgical resection. Studies of patients with pancreatic tumors incidentally diagnosed demonstrate longer median survival than tumors discovered only when the patient is symptomatic, suggesting that early detection may improve outcome. Recent evidence from genomic sequencing indicates a 15-year interval for genetic progression of pancreatic cancer from initiation to the metastatic stage, suggesting a sufficient window for early detection. Still, many challenges remain in implementing effective screening. Early diagnosis of pancreatic cancer relies on developing screening methodologies with highly sensitive and specific biomarkers and imaging modalities. It also depends on a better understanding of the risk factors and natural history of the disease to accurately identify high-risk groups that would be best served by screening. This review summarizes our current understanding of the biology of pancreatic cancer relevant to methods available for screening. At this time, given the lack of proven benefit in this disease, screening efforts should probably be undertaken in the context of prospective trials. Pancreatic adenocarcinoma is a largely fatal disease with increased survival for patients with localized disease compared with those with distant metastases. A critical evaluation of early detection strategies is presented in light of results from more common cancers. Improved outcomes may be attained by focusing screening on high-risk groups; however, these efforts are as yet unproven.

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Authors: Poruk, K. E., Firpo, M. A., Adler, D. G., & Mulvihill, S. J.
Affiliations: University of Utah (US)
Corresponding author: Poruk, Katherine E.
ORCID: Poruk, Katherine E.
Firpo, Matthew A.
Adler, Douglas G.
Mulvihill, Sean J.
Venue: Annals of Surgery
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2013-01
Volume: 257
Issue: 1
Pages: 17-26
ISSN: 0003-4932 (ISSN-L)
DOI: 10.1097/sla.0b013e31825ffbfb
PMC: PMC4113008
OpenAlex: W2050410927
Cited by: 249
References: 117
Citations by year: 2026: 5 · 2025: 12 · 2024: 16 · 2023: 25 · 2022: 33 · 2021: 16 · 2020: 24 · 2019: 25 · 2018: 14 · 2017: 25 · 2016: 18 · 2015: 15 · 2014: 15 · 2013: 4
FWCI: 1.16
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Annals of Surgery (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Heart, Lung, and Blood Institute (T35HL007744)
National Cancer Institute (U01CA151650, R03CA115225, U01CA15165, R33CA155586, P30CA042014)
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 cancer, cancer screening, early detection, pancreatic ductal adenocarcinoma, biomarkers, imaging modalities, high-risk groups, risk factors, natural history of disease, resectability, survival
MeSH terms: Adenocarcinoma, Humans, Magnetic Resonance Imaging, Pancreatic Neoplasms, Precancerous Conditions, Risk Factors, Sensitivity and Specificity, Tomography, X-Ray Computed, Biomarkers, Tumor, United States, Endosonography, Early Detection of Cancer

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