Screening for pancreatic cancer: a review for general clinicians

Rom J Intern Med. 2020 Sep 1;58(3):119-128. doi: 10.2478/rjim-2020-0009.

Abstract

Pancreatic cancer (PC) is an exceptionally lethal malignancy with increasing incidence and mortality worldwide. One of the principal challenges in the treatment of PC is that the diagnosis is usually made at a late stage when potentially curative surgical resection is no longer an option. General clinicians including internists and family physicians are well positioned to identify high-risk individuals and refer them to centers with expertise in PC screening and treatment where screening modalities can be employed. Here, we provide an up-to-date review of PC precursor lesions, epidemiology, and risk factors to empower the general clinician to recognize high-risk patients and employ risk reduction strategies. We also review current screening guidelines and modalities and preview progress that is being made to improve screening tests and biomarkers. It is our hope that this review article will empower the general clinician to understand which patients need to be screened for PC, strategies that may be used to reduce PC risk, and which screening modalities are available in order to diminish the lethality of PC.

Keywords: biomarkers; cancer screening; pancreatic cancer; risk factors; risk reduction.

Publication types

  • Review

MeSH terms

  • CA-19-9 Antigen / blood
  • Carcinoembryonic Antigen / blood
  • Carcinoma, Pancreatic Ductal / diagnosis*
  • Carcinoma, Pancreatic Ductal / epidemiology
  • Early Detection of Cancer* / methods
  • Early Detection of Cancer* / standards
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration
  • Endosonography
  • Humans
  • Magnetic Resonance Imaging
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / epidemiology
  • Practice Guidelines as Topic
  • Precancerous Conditions / diagnosis*
  • Risk Factors

Substances

  • CA-19-9 Antigen
  • Carcinoembryonic Antigen