How to Screen for Pancreatic Cancer

Pancreatic cancer evaluation using CT MRI and endoscopic ultrasound

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Pancreatic cancer is difficult to detect, and by the time someone has symptoms that send them to the doctor, the cancer may have advanced to the point where it is difficult to treat.

A group of researchers compared results from several types of imaging on asymptomatic patients who were at high risk for developing pancreatic cancer.

Looking at MRI, CT and endoscopic ultrasound scans, they concluded that endoscopic ultrasound was significantly better at detecting the presence of any pancreatic lesions than the alternatives.

"Ask your doctor about pancreatic cancer therapies."

The researchers, from Johns Hopkins, concluded that screening of patients at a high risk of developing pancreatic cancer was worthwhile, even if no symptoms were present, noting that screening frequently detected small cysts in the pancreas, some of which were curable, noninvasive high-grade neoplasms.

Ultrasound scans given endoscopically. Use of MRI or ultrasound technology performed far better than the CT scan in detecting any lesions of the pancreas.

Researchers studied 225 patients without any symptoms of cancer, who had been previously identified as having a high risk for developing pancreatic cancer. Doctors interpreting the imaging results were not informed of the conclusions from other imaging technologies.

Scans performed on all 225 patients by CT detected pancreatic abnormalities in 11 percent of all the patients, 33.3 percent when MRI was used, and endoscopic ultrasound found abnormalities in 42.6 percent of all patients.

Out of the 225 enrolled in the study, 92 patients had a pancreatic mass, 51 of which were multiple, and signs of cancer was identified in 85 of those cases. Of the five patients sent to surgery, three had high grade cancers.

Marcia Irene Canto, MD, a gastroenterologist from John Hopkins led the study. The team said their results matched earlier studies where the amount of pancreatic lesions rises with age when individuals are at high risk.

Few lesions develop into cancer, but often indicate pancreatic damage and may be the only warning sign before cancer develops.

Dr. Canto believes that screening high risk populations will give the best results. "Early detection is the way to go," Dr. Canto stated. "We need smart screening and individualized treatments based on family history, epidemiology, biomarkers and genetics."

Patients were screened using CT, MRI, and endoscopic ultrasound independently and then data results were compared. Screening for pancreatic cancer is not recommended for the general population as it is rare, and treatment options are limited and serious complications may result.

As concluded from other studies, high risk classification involved several factors including obesity, diabetes, extreme levels of alcohol use or other forms of heavy liver damage, and smoking, but hereditary risk alone may account for ten 10 percent of cases.

Patients examined in the study were noted to have an increased risk of cancer ranging from 3X to as high as 130X the normal risk. Lifetime risk of pancreatic cancer is about 1 per every 200 people.

Research was published in the journal Gastroenterology on January 16, 2012.

Study authors stated there were no financial conflicts of interest regarding this research, and funding was provided by the National Cancer Institute, the Lustgarten Foundation for Pancreatic Cancer Research, the Michael Rolfe Foundation, the Olympus Corporation, Cook Medical, the Karp Family H.H. & M. Metals, Inc, Fund for Cancer Research, and ChiRhoClin.

Reviewed by: 
Review Date: 
April 17, 2012
Last Updated:
April 19, 2012