Assessment of the Psychosocial Impact of Pancreatic Cancer Surveillance in High-Risk Individuals

Abstract

Objectives: Pancreatic cancer (PC) surveillance of high-risk individuals (HRIs) downstages PC and improves survival. However, it remains less clear whether PC surveillance has a positive psychosocial impact on HRIs. Herein, we aimed to define the attitudes and beliefs of HRIs undergoing PC surveillance, and the immediate and sustained psychosocial impact of PC surveillance in HRIs.

Methods: 100 HRIs undergoing PC surveillance by endoscopic ultrasound (EUS) completed three surveys addressing different components of the psychosocial impact of PC surveillance. Logistic regression analyses were performed to identify predictive factors relating to these components.

Results: Most HRIs reported increased perceived benefits of PC surveillance, self-efficacy, and perceived severity of PC. HRIs reported few negative emotions prior to surveillance and frequent positive emotions after surveillance. Compared to prior to surveillance, there was a 53.5% decrease in the level of distress reported by HRIs after surveillance, which was sustained for 4-6 weeks post-surveillance. Family history of PC and lower self-reported mental health were identified as predictors for increased perceived susceptibility to PC (p < 0.01) and greater change in distress pre- to post-surveillance (p < 0.01), respectively.

Conclusions: Our findings suggest that PC surveillance can lead to sustained psychosocial benefits in HRIs.

Keywords: endoscopic ultrasound; familial pancreatic cancer; hereditary pancreatic cancer risk.

Figure 1

Self-reported motivations for HRIs to undergo pancreatic cancer surveillance.

Figure 2

Distribution of responses to questions assessing perceived susceptibility to PC or precancerous lesions in the pancreas.

Figure 3

Emotional consequences of PC surveillance. (A) Distribution of responses assessing negative emotional effects of having to undergo surveillance (green). (B) Distribution of positive emotional effects immediately after surveillance (red) and 4–6 weeks after surveillance (blue).

Figure 4

Distribution of distress levels reported before, immediately after, and 4–6 weeks after EUS. Mean distress score before EUS = 3.14 (SEM 0.27, 95% CI 2.60–3.68), immediately after EUS = 1.46 (SEM 0.19, 95% CI 1.08–1.84), and 4–6 weeks after EUS = 1.57 (SEM 0.18, 95% CI 1.21–1.93). * p < 0.01.