Pancreatic cancer (PC) screening recommendations have been based on studies performed solely at high-volume academic centers. In order to make PC screening more widely available, community-based efforts are essential. We implemented a prospective PC screening study in the community of Fairfield County, CT and report our early safety and efficacy results.
Eligible individuals were enrolled into an investigator-initiated study and underwent a baseline and three annual MRI/MRCPs with gadolinium, bi-annual blood donations for biobanking and assessments for anxiety and depression. All MRIs were presented at a multidisciplinary board, to determine if further investigation was warranted.
Seventy-five individuals have been enrolled and 201 MRIs performed over a 2.6 year average length of follow-up. Abnormal pancreatic findings (predominantly small cysts) were detected in 58.7% of participants. Among these, 6.7% underwent EUS with one case complicated by post-procedural pancreatitis. One surgical resection was performed on a 4.7 cm intraductal papillary mucinous neoplasm with a focus of low-grade pancreatic intraepithelial neoplasia. One incidental finding of fibrosing mediastinitis was detected. Anxiety and depression scores decreased over the course of the study from 21.4% to 5.4% and 10.7% to 3.6%, respectively.
This preliminary report supports the feasibility of performing MRI/MRCP-based PC screening as part of a clinical trial in a community setting. Longer follow-up is needed to better assess safety and efficacy. To our knowledge, this is the first report from a community-based PC screening effort. (clinicaltrials.govID: NCT03250078).\