As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF), in a reaffirmation of its 2004 recommendation, has recommended against screening for pancreatic cancer in asymptomatic adults (a grade D recommendation).¹

In developing the current recommendation, the USPSTF reviewed evidence on benefits and harms of screening, diagnostic accuracy of screening tests, and benefits and harms of treatment of screen-detected or asymptomatic pancreatic cancer.

Recommendation Key Points

The USPSTF does not recommend screening for pancreatic cancer in the general population using any method. Imaging-based methods—such as computed tomography, magnetic resonance imaging, and endoscopic ultrasonography—have been studied as screening tests in trials in persons at high risk of pancreatic cancer due to inherited genetic syndromes or familial pancreatic cancer. There are currently no accurate, validated biomarkers for the early detection of pancreatic cancer.

The recommendation does not apply to individuals with a high risk of pancreatic cancer, such as those with certain inherited genetic syndromes or a history of familial pancreatic cancer. However, the recommendation does apply to asymptomatic persons with factors that are associated with a lesser increase in risk, such as new-onset diabetes, preexisting diabetes, older age, cigarette smoking, obesity, or history of chronic pancreatitis.

The USPSTF found no evidence that screening for pancreatic cancer or treatment of screen-detected pancreatic cancer improves disease-specific morbidity or mortality or all-cause mortality. But it found adequate evidence that the magnitude of the benefits of screening in asymptomatic adults can be bounded as no greater than small, and that the magnitude of the harms of screening and treatment of screen-detected disease can be bounded as at least moderate.

Thus, thee USPSTF reaffirmed its previous conclusion that the potential benefits of screening for pancreatic cancer in asymptomatic adults do not outweigh the potential harms. The authors concluded, “USPSTF recommends against screening for pancreatic cancer in asymptomatic adults.”

Douglas K. Owens, MD, MS, of Stanford University, is the corresponding author for the JAMA article. ■

Disclosure: The USPSTF is an independent, voluntary body. The U.S. Congress mandates that the Agency for Healthcare Research and Quality support the operations of the USPSTF. For full disclosures of the study authors, visit jamanetwork.com.

Reference

1. US Preventive Services Task Force (USPSTF): Screening for pancreatic cancer: USPSTF Reaffirmation Recommendation Statement. JAMA 322:438-444, 2019.