The Doctors of the National and Kapodistrian University of Athens (EKPA) Therapeutic Clinic summarise recent research data on the importance of annual preventive checkups for high-risk individuals.
Pancreatic cancer is the fourth leading cause of death in Europe, accounting for 7.4% of cancer deaths. Although the five-year survival rate has increased from 5% to 12% compared to previous decades, the prognosis remains unfavourable.
Given that pancreatic cancer is asymptomatic in the initial stages, with the result that 80% of patients are already diagnosed with advanced disease, there is a need for preventive screening of people, especially individuals who are at an increased risk.
People at increased risk for pancreatic cancer are those with a family history of the disease or with inherited mutations.
Inherited mutations in the BRCA and PALB2 genes that predispose to pancreatic cancer are found in 5-9% of patients, while when there is a positive family history, this frequency, especially for BRCA2 mutations, increases to 17%.
Other mutations predisposing to pancreatic cancer are those in the ATM gene (2.4% of patients with a positive family history) and PALB2 (1-5%).
In recent years, it has been recommended preventive screening for pancreatic cancer should be done by relatives of patients who have already been diagnosed. However, there's no clear guidelines for which test should be performed or the age at which screening should start.
The Doctors of the Therapeutic Clinic (Alexandra Hospital) Theodora Psaltopoulou (Pathologist, Professor of Therapeutic-Epidemiology-Preventive Medicine), Dr Angeliki Andrikopoulou and Thanos Dimopoulos (former Rector EKPA, Professor of Therapeutics - Oncology - Hematology, Director of Therapeutic Clinic) of the Medical School of EKPA, report that a study was recently published in the prestigious journal Jama Oncology according to which, the annual preventive check-up with endoscopic ultrasound (EUS) or magnetic resonance imaging (MRI) in people at high risk for developing pancreatic cancer, i.e. people with a positive family history or carriers of a pathogenic mutation, has led to earlier diagnosis, more radical surgical treatment and therefore increased patient survival.
Specifically, the study showed that annual screening led to a diagnosis at an earlier stage of the disease: 38.5% and 30.8% of patients were diagnosed with stage I and II disease, respectively, compared to only 10.3% and 25.1%, respectively, in the control group.
At the same time, screening increased the five-year survival rate (50% vs. 9%) and the median overall survival from 8 to 61.7 months.
This study showed that screening people at high risk for developing pancreatic cancer leads to the diagnosis of smaller tumours at an earlier stage and improved survival in these patients.
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