Early detection of pancreatic cancer

Abstract

Pancreatic ductal adenocarcinoma is most frequently detected at an advanced stage. Such late detection restricts treatment options and contributes to a dismal 5-year survival rate of 3-15%. Pancreatic ductal adenocarcinoma is relatively uncommon and screening of the asymptomatic adult population is not feasible or recommended with current modalities. However, screening of individuals in high-risk groups is recommended. Here, we review groups at high risk for pancreatic ductal adenocarcinoma, including individuals with inherited predisposition and patients with pancreatic cystic lesions. We discuss studies aimed at finding ways of identifying pancreatic ductal adenocarcinoma in high-risk groups, such as among individuals with new-onset diabetes mellitus and people attending primary and secondary care practices with symptoms that suggest this cancer. We review early detection biomarkers, explore the potential of using social media for detection, appraise prediction models developed using electronic health records and research data, and examine the application of artificial intelligence to medical imaging for the purposes of early detection.

Figure 1:. Overview of screening programmes for pancreatic ductal adenocarcinoma

PDAC=pancreatic ductal adenocarcinoma.

Figure 2:. Early detection strategies for pancreatic ductal adenocarcinoma, including identifying high-risk groups, creating resources, developing biomarkers, and constructing prediction models from medical health records and research databases

Early detection efforts for pancreatic cancer (from top left, counterclockwise) include biospecimens from multiple locations (mouth, blood, electronic medical record, urine, stool, tissue) and deep learning applied to diagnostic imaging. Interpretation and integration of these sources of data, and other emerging areas such as synthetic biomarkers, will be key areas of research in the future.