Screening and early detection of pancreatic cancer in high risk population

Chang, Ming‐Chu; Wong, Jau‐Min; Chang, Yu-Ting

doi:10.3748/wjg.v20.i9.2358

Cited by 43 publications

(36 citation statements)

References 45 publications

(60 reference statements)

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“…However, the radiation risk and contrast agent exposure during CT examination makes this modality not suitable for routine screening and surveillance. The long durability of MRI examination time and the cost also become debatable matters when using this modality for early detection and screening in general population 9, 10, 11…”

Section: Discussionmentioning

confidence: 99%

Non‐alcoholic fatty pancreas disease as a risk factor for pancreatic cancer based on endoscopic ultrasound examination among pancreatic cancer patients: A single‐center experience

2017

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Background and AimNon‐alcoholic fatty pancreas disease (NAFPD) is a disease that ranges from simple steatosis and can further lead to chronic pancreatitis and possible pancreatic cancer development. Its exact pathogenesis and impact on clinical practice are still largely unknown. Pancreatic cancer is still the most lethal malignancy in the world. Studies about the relationship between NAFPD and pancreatic cancer are still lacking. This study aims to find the possible role of endoscopic ultrasound (EUS) examination as a screening tool in NAFPD patients based on EUS examination among pancreatic cancer patients.MethodsEUS hospital data were collected within a 2‐year period, and all patients who underwent EUS procedures were analyzed. Pancreatic malignancy was diagnosed based on imaging and tumor markers and cytopathology using the endoscopic ultrasound fine needle aspiration (EUS‐FNA) procedure. Patients with pre‐existing pancreatic diseases, significant alcohol consumption, or other primary cancer with metastasis to the pancreas were excluded. Statistical analysis was performed using SPSS version 23.0.ResultsIn total, 162 patients (75 females and 87 males) were recruited for database analysis.^ Pancreatic malignancy was found in 43 (26.5%) patients, whereas fatty pancreas was found in 53 (32.7%) patients, and this was commonly found among pancreatic cancer patients.^ Based on logistic regression analysis, factors such as age, gender, diabetes, and chronic pancreatitis were not found to be significant risk factors for pancreatic malignancy where fatty pancreas is the only significant risk factor for pancreatic cancer (odds ratio: 18.027 [95% CI: 7.288–44.588]).ConclusionPrevalence of NAFPD among pancreatic cancer patients is high. Future studies can be conducted to show whether EUS can be considered a screening tool for the early detection of pancreatic malignancy in NAFPD patients; a cohort prospective study might also be needed to show clear causality between fatty pancreas and pancreatic cancer.

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Section: Discussionmentioning

confidence: 99%

Non‐alcoholic fatty pancreas disease as a risk factor for pancreatic cancer based on endoscopic ultrasound examination among pancreatic cancer patients: A single‐center experience

2017

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“…It is considered to be amongst the 10 most common tumors affecting the population of the United States, with the number of expected deaths in 2015 equaling approximately 80% of the estimated new cases (1) . One of the main reasons for such a high death rate and unfavorable prognosis is related to late diagnosis; the first symptoms appear after approximately a decade of pancreatic carcinogenesis, when the tumor has reached an advanced stage 2 , 3 . As a consequence, only 20% of pancreatic cancer patients are candidates for surgery, (4) as the majority of pancreatic cancer patients show locally advanced or metastatic disease.…”

Section: Introductionmentioning

confidence: 99%

MRI quantification of pancreas motion as a function of patient setup for particle therapy —a preliminary study

Fontana

Riboldi

Gianoli

et al. 2016

J Applied Clin Med Phys

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Particle therapy (PT) has shown positive therapeutic results in local control of locally advanced pancreatic lesions. PT effectiveness is highly influenced by target localization accuracy both in space, since the pancreas is located in proximity to radiosensitive vital organs, and in time as it is subject to substantial breathing‐related motion. The purpose of this preliminary study was to quantify pancreas range of motion under typical PT treatment conditions. Three common immobilization devices (vacuum cushion, thermoplastic mask, and compressor belt) were evaluated on five male patients in prone and supine positions. Retrospective four‐dimensional magnetic resonance imaging data were reconstructed for each condition and the pancreas was manually segmented on each of six breathing phases. A k‐means algorithm was then applied on the manually segmented map in order to obtain clusters representative of the three pancreas segments: head, body, and tail. Centers of mass (COM) for the pancreas and its segments were computed, as well as their displacements with respect to a reference breathing phase (beginning exhalation). The median three‐dimensional COM displacements were in the range of 3 mm. Latero–lateral and superior–inferior directions had a higher range of motion than the anterior–posterior direction. Motion analysis of the pancreas segments showed slightly lower COM displacements for the head cluster compared to the tail cluster, especially in prone position. Statistically significant differences were found within patients among the investigated setups. Hence a patient‐specific approach, rather than a general strategy, is suggested to define the optimal treatment setup in the frame of a millimeter positioning accuracy.PACS number(s): 87.55.‐x, 87.57.nm, 87.61

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“…It remains a concern that screening for pancreatic cancer could do more harm than any potential benefit. Many clinical risk factors associated with pancreatic cancer have been identified as age, obesity, smoking, diabetes, and chronic pancreatitis; however, the specificity of these factors to pancreatic cancer is low [15].…”

Section: High-risk Populations Need Pancreatic Cancer Screeningmentioning

confidence: 99%

“…International cancer of the pancreas screening (CAPS) has proposed a definition of ''successful screening", which is the detection and treatment of T1N0M0 margin negative pancreatic cancer and high grade dysplasia, including intraepithelial pancreatic neoplasia-3 (PanIN-3), intraductal papillary mucinous neoplasm (IPMN) with high grade dysplasia, and mucinous cystic neoplasm with high grade dysplasia [15]. Pancreatic cancer has been identified to be a rapidly progressing pathology.…”

Section: Successful Screeningmentioning

confidence: 99%

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Pancreatic Cancer Screening: Attempts and Possibilities

Mourad¹,

Evans²,

Aly³

et al. 2017

J Hepatol Gastroint Dis

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Pancreatic cancer has one of the highest disease specific mortality of any malignancy, despite significant advances in diagnosis and treatment over the past decade. Currently there are no efficient screening tools available that can be recommended outside a high-risk population. Screening of high-risk populations has been suggested for early detection of curable pancreatic cancer to improve outcome. There is still however, a lack of an ideal screening method. Efficient and reliable screening methods to achieve early detection of pancreatic cancer are therefore required.

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Screening and early detection of pancreatic cancer in high risk population

Cited by 43 publications

References 45 publications

Non‐alcoholic fatty pancreas disease as a risk factor for pancreatic cancer based on endoscopic ultrasound examination among pancreatic cancer patients: A single‐center experience

Non‐alcoholic fatty pancreas disease as a risk factor for pancreatic cancer based on endoscopic ultrasound examination among pancreatic cancer patients: A single‐center experience

MRI quantification of pancreas motion as a function of patient setup for particle therapy —a preliminary study

Pancreatic Cancer Screening: Attempts and Possibilities

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