USPSTF Updates Pancreatic Screening Recommendations
The United States Preventative Services Task Force (USPSTF) recently published an updated evidence report, with recommendations, regarding pancreatic cancer screening. The systematic review was published on August 6, 2019 in JAMA.
Pancreatic cancer is often referred to a as a death sentence. While survival rates have increased over the past decade, the American Cancer Society reports the 5-year relative survival rate for pancreatic adenocarcinoma, regardless of stage, is approximately 9%—and it remains the third most common cause of cancer death among both men and women in the United States. Given the mortality rates associated with this form of cancer, many have hoped that appropriate screenings could help physicians diagnose the disease earlier, ensuring that patients are treated in a timely fashion and, ultimately, increasing the odds of survival. But the current USPSTF recommendation, published in 2004, recommended against pancreatic cancer screening in adults who were not experiencing symptoms.
To investigate whether that recommendation should be revised, the USPSTF undertook a systematic review of more than 800 full-text articles, published between 2002 and 2019, investigating the benefits and harms of pancreatic screenings, including endoscopic ultrasound, MRI, and CT. Those papers included 13 unique studies, of more than 1300 individuals, who had an elevated familiar risk for the condition.
The Task Force researchers concluded there is limited evidence to suggest that pancreatic screening can improve morbidity or mortality—or, even, to accurately weigh the benefits versus harms of screening.
That said, they have updated their recommendations to say that image-based screening of patients with a high familial risk of disease, defined as two or more blood relatives affected by pancreatic cancer or as having specific mutations in certain genes, can be done without excess harm.
They do not recommend that asymptomatic adults be screened.