In a study reported in JAMA Oncology, Blackford et al found that surveillance of individuals at high risk for pancreatic ductal adenocarcinoma allowed for detection of earlier-stage pancreatic ductal adenocarcinoma—with improved survival—compared with matched pancreatic ductal adenocarcinoma controls.
Study Details
The study involved data from multiple U.S. centers participating in the Cancer of the Pancreas Screening program, which screens high-risk individuals with a familial or genetic predisposition for pancreatic ductal adenocarcinoma; screening includes annual endoscopic ultrasonography or magnetic resonance imaging. The comparison cohort consisted of patients with pancreatic ductal adenocarcinoma matched for age, sex, and year of diagnosis from the SEER (Surveillance, Epidemiology, and End Results) program.
Key Findings
A total of 26 high-risk individuals with pancreatic ductal adenocarcinoma diagnosed through surveillance (mean age at diagnosis = 65.8 years; 57.7% female) were compared with 1,504 SEER control patients with pancreatic ductal adenocarcinoma (mean age at diagnosis = 66.8 years; 51.3% female).
At diagnosis, the median primary tumor diameter was 2.5 cm (range = 0.6–5.0 cm) among the 26 surveillance patients vs 3.6 cm (range = 0.2–8.0 cm) among control patients (P < .001). The surveillance patients were also more likely (P < .001) to have lower-stage disease at diagnosis (stage I = 38.5%, stage II = 30.8%) vs control patients (stage I = 10.3%, stage II = 25.1%).
The pancreatic ductal adenocarcinoma mortality rate at 5 years was 86% among control patients vs 43% among surveillance patients (hazard ratio [HR] = 3.58, 95% confidence interval [CI] = 2.01–6.39, P < .001). Median overall survival was 61.7 months (range = 1.9–147.3 months) among surveillance patients vs 8.0 months (range = 1.0–131.0 months) among control patients; the 5-year overall survival rate was 50% vs 9%.
The investigators concluded: “These findings suggest that surveillance of high-risk individuals may lead to detection of smaller, lower-stage pancreatic ductal adenocarcinomas and improved survival.”
Marcia Irene Canto, MD, MHS, of the Division of Gastroenterology, Johns Hopkins Medicine, is the corresponding author of the JAMA Oncology article.
Disclosure: The study was supported by the National Institutes of Health and others. For full disclosures of the study authors, visit jamanetwork.com.
