J. T. Wiseman1, R. Hendrix1, W. Y. Wassef2, K. Flores3, A. Friedrich1, K. Dinh1, E. Rouanet1, G. Whalen1, J. LaFemina1 1University Of Massachusetts,Surgical Oncology,Worcester, MA, USA 2University Of Massachusetts,Gastroenterology,Worcester, MA, USA 3University Of Massachusetts,Pediatrics,Worcester, MA, USA
Introduction: Pancreatic ductal adenocarcinoma (PDAC) is the 3rd most common cause of cancer death in the United States. As there is no definitive impact of screening on cure, the role of screening high risk cohorts remains controversial. Furthermore, no gold standard screening pathway has been established. Herein we present our initial experience, focusing on the radiologic and endoscopic findings of high-risk subject screening.
Methods: Subjects were eligible if they were determined to be at intermediate or high personal risk for PDAC as determined by one of the following: personal/family history of a genetic syndrome associated with PDAC; personal history of chronic pancreatitis of unknown etiology; or family history of PDAC. Subjects were recruited from May 2013-November 2015. The screening and evaluation algorithm is summarized in Figure 1. Analysis is conducted on the radiologic and endoscopic pancreatic findings in all new patients. Subjects with known PDAC were excluded.
Results: Sixty-eight patients were analyzed during the study period. The average age was 55 years (range: 22-82 years) and 78% were female gender. There were 43 (63%) subjects who completed an MRCP or CT-scan of the abdomen. Fifty-three (78%) subjects completed an endoscopic ultrasound. Precancerous cyst(s) were found in 16% of subjects; 50% were newly diagnosed. Chronic pancreatitis was found in 65% of subjects; 32% were newly diagnosed.
Conclusion: We demonstrate that in a moderate/high-risk population for PDAC, the rate of detecting precancerous findings is acceptable and greater than expected. While it is too early to determine the current impact of a successful screening protocol for PDAC on survival, we believe early diagnosis will lead to earlier treatment and subsequent improvement in patient outcomes.
