Pancreatic Cancer Screening for At-Risk Individuals (Pancreas Scan Study): Yield, Harms, and Outcomes From a Prospective Multicenter Study : Official journal of the American College of Gastroenterology | ACG

Secondary Logo

Journal Logo

Advanced Search
ARTICLES: PANCREAS

Pancreatic Cancer Screening for At-Risk Individuals (Pancreas Scan Study): Yield, Harms, and Outcomes From a Prospective Multicenter Study

Shah, Ishani MD1,*; Silva-Santisteban, Andy MD1,*; Germansky, Katharine A. MD1; Trindade, Arvind MD2; Raphael, Kara L. MD2; Kushnir, Vladimir MD3; Pawa, Rishi MD4; Mishra, Girish MD4; Anastasiou, Jiannis MD5; Inamdar, Sumant MD5; Tharian, Benjamin MD5; Bilal, Mohammad MD1; Sawhney, Mandeep S. MD, MS1

Author Information

1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts, USA;

2Division of Gastroenterology and Hepatology, Department of Internal Medicine, Zucker School of Medicine at Hofstra/Northwell, Long-Island Jewish Hospital, Great Neck, New York, USA;

3Division of Gastroenterology and Hepatology, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA;

4Division of Gastroenterology and Hepatology, Department of Internal Medicine, Wake Forest University Health Sciences, Winston-Salem, North Carolina, USA;

5Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Arkansas Medical Sciences, Little Rock, Arkansas, USA.

Correspondence: Mandeep S. Sawhney, MD, MS. E-mail: [email protected].

SUPPLEMENTARY MATERIAL accompanies this paper at https://links.lww.com/AJG/C950

*Ishani Shah and Andy Silva-Santisteban contributed equally to study.

The American Journal of Gastroenterology 118(9):p 1664-1670, September 2023. | DOI: 10.14309/ajg.0000000000002314

Abstract

INTRODUCTION: 

Guidelines endorse pancreatic cancer screening in genetically susceptible individuals. We conducted a prospective, multicenter study to determine yield, harms, and outcomes of pancreatic cancer screening.

METHODS: 

All high-risk individuals undergoing pancreatic cancer screening at 5 centers from 2020 to 2022 were prospectively enrolled. Pancreas findings were designated as low-risk (fatty or chronic pancreatitis-like changes), intermediate-risk (neuroendocrine tumor [NET] <2 cm or branch-duct intraductal papillary mucinous neoplasm [IPMN]), or high-risk lesions (high-grade pancreatic intraepithelial neoplasia/dysplasia, main-duct IPMN, NET >2 cm, or pancreatic cancer). Harms from screening included adverse events during screening or undergoing low-yield pancreatic surgery. Annual screening was performed using endoscopic ultrasound and or magnetic resonance cholangiopancreatography. Annual screening for new-onset diabetes using fasting blood sugar was also performed (ClinicalTrials.gov: NCT05006131).

RESULTS: 

During the study period, 252 patients underwent pancreatic cancer screening. Mean age was 59.9 years, 69% were female, and 79.4% were White. Common indications were BRCA 1/2 (36.9%), familial pancreatic cancer syndrome kindred (31.7%), ataxia telangiectasia mutated (3.5%), Lynch syndrome (6.7%), Peutz-Jeghers (4.3%), and familial atypical multiple mole melanoma (3.5%). Low-risk lesions were noted in 23.4% and intermediate-risk lesions in 31.7%, almost all of which were branch-duct IPMN without worrisome features. High-risk lesions were noted in 2 patients (0.8%), who were diagnosed with pancreas cancer at stages T2N1M0 and T2N1M1. Prediabetes was noted in 18.2% and new-onset diabetes in 1.7%. Abnormal fasting blood sugar was not associated with pancreatic lesions. There were no adverse events from screening tests, and no patient underwent low-yield pancreatic surgery.

DISCUSSION: 

Pancreatic cancer screening detected high-risk lesions with lower frequency than previously reported. No harms from screening were noted.

© 2023 by The American College of Gastroenterology

Full Text Access for Subscribers:

Log In Here
ACG Member Access
Log In Here

Not a Subscriber?

Buy
Request Permissions

You can read the full text of this article if you:

Access through Ovid