Open AccessScreening of Pancreatic Cancer for Early Diagnosis
Author(s) -
장재혁
Publication year - 2021
Publication title -
the korean journal of medicine
Language(s) - English
Resource type - Journals
eISSN - 2289-0769
pISSN - 1738-9364
DOI - 10.3904/kjm.2021.96.2.110
Subject(s) - overdiagnosis , medicine , modalities , pancreatic cancer , stage (stratigraphy) , pancreatitis , disease , intensive care medicine , population , diabetes mellitus , pancreatic ductal adenocarcinoma , cancer , paleontology , social science , environmental health , sociology , biology , endocrinology
Over 80% of patients with pancreatic ductal adenocarcinomas (PDAs) present with symptomatic, surgically unresectable disease. If a “stage shift” from the current 20% proportion of resectability to early detection could be achieved, this would greatly improve the survival of patients with this generally dismal disease. Although the goal of early detection is laudable, the relatively low prevalence of PDA renders general population screening unfeasible. To avoid the perils of overdiagnosis and to focus early detection efforts on individuals deemed to be at higher-than-average risk, we need to define such subsets of individuals, such as kindred of existing patients and those with precursor cystic lesions, chronic pancreatitis, and new-onset diabetes. The next step is to determine when and how often to monitor at-risk individuals and the diagnostic modalities that will be employed in the surveillance. Enormous challenges remain in terms of validated blood-based biomarkers, imaging modalities, and when and how often surveillance.