Early Detection of Sporadic Pancreatic Ductal Adenocarcinoma: Problems, Promise, and Prospects
Authors: Suresh T. Chari, Ayush Sharma, Anirban Maitra
Journal: Annals of Internal Medicine (2020)

Ideas and Opinions21 April 2020Early Detection of Sporadic Pancreatic Ductal Adenocarcinoma: Problems, Promise, and ProspectsSuresh T. Chari, MD, Ayush Sharma, MBBS, and Anirban Maitra, MBBSSuresh T. Chari, MDUniversity of Texas MD Anderson Cancer Center, Houston, Texas (S.T.C., A.M.), Ayush Sharma, MBBSMayo Clinic, Rochester, Minnesota (A.S.), and Anirban Maitra, MBBSUniversity of Texas MD Anderson Cancer Center, Houston, Texas (S.T.C., A.M.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-2336 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Sporadic (nonfamilial) pancreatic ductal adenocarcinoma (PDAC) is a devastating cancer, and its 5-year overall rate of survival in the United States is dismal (5%) (1). In persons without a family history of pancreatic cancer, lifetime risk for PDAC is about 1.6% (1). The National Cancer Institute estimated that in 2019 in the United States, 56 770 persons would be diagnosed with PDAC and more than 45 750 would die of the disease, making it the third leading cause of cancer death (2). By the time symptoms develop and a diagnosis is made, 85% of PDAC tumors are deemed unresectable (1). In less ...References1. Chari ST, Kelly K, Hollingsworth MA, et al. Early detection of sporadic pancreatic cancer: summative review. Pancreas. 2015;44:693-712. [PMID: 25931254] doi:10.1097/MPA.0000000000000368 CrossrefMedlineGoogle Scholar2. National Cancer Institute. SEER Cancer Stat Facts: Pancreatic Cancer. Accessed at http://seer.cancer.gov/statfacts/html/pancreas.html on 17 August 2019. Google Scholar3. U.S. Preventive Services Task Force. Pancreatic cancer: screening. 2019. Accessed at www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/pancreatic-cancer-screening1 on 29 August 2019. Google Scholar4. Corral JE, Mareth KF, Riegert-Johnson DL, et al. Diagnostic yield from screening asymptomatic individuals at high risk for pancreatic cancer: a meta-analysis of cohort studies. Clin Gastroenterol Hepatol. 2019;17:41-53. [PMID: 29775792] doi:10.1016/j.cgh.2018.04.065 CrossrefMedlineGoogle Scholar5. Pannala R, Basu A, Petersen GM, et al. New-onset diabetes: a potential clue to the early diagnosis of pancreatic cancer. Lancet Oncol. 2009;10:88-95. [PMID: 19111249] doi:10.1016/S1470-2045(08)70337-1 CrossrefMedlineGoogle Scholar6. Sah RP, Sharma A, Nagpal S, et al. Phases of metabolic and soft tissue changes in months preceding a diagnosis of pancreatic ductal adenocarcinoma. Gastroenterology. 2019;156:1742-52. [PMID: 30677401] doi:10.1053/j.gastro.2019.01.039 CrossrefMedlineGoogle Scholar7. Sharma A, Smyrk TC, Levy MJ, et al. Fasting blood glucose levels provide estimate of duration and progression of pancreatic cancer before diagnosis. Gastroenterology. 2018;155:490-500. [PMID: 29723506] doi:10.1053/j.gastro.2018.04.025 CrossrefMedlineGoogle Scholar8. Sharma A, Kandlakunta H, Nagpal SJS, et al. Model to determine risk of pancreatic cancer in patients with new-onset diabetes. Gastroenterology. 2018;155:730-9. [PMID: 29775599] doi:10.1053/j.gastro.2018.05.023 CrossrefMedlineGoogle Scholar9. Singhi AD, Koay EJ, Chari ST, et al. Early detection of pancreatic cancer: opportunities and challenges. Gastroenterology. 2019;156:2024-40. [PMID: 30721664] doi:10.1053/j.gastro.2019.01.259 CrossrefMedlineGoogle Scholar10. Maitra A, Sharma A, Brand RE, et al; Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC). A prospective study to establish a new-onset diabetes cohort: from the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer. Pancreas. 2018;47:1244-8. [PMID: 30325864] doi:10.1097/MPA.0000000000001169 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Texas MD Anderson Cancer Center, Houston, Texas (S.T.C., A.M.)Mayo Clinic, Rochester, Minnesota (A.S.)Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or any other funding source.Grant Support: By the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (grant NIH DK108288) (Drs. Chari and Maitra); the Kenner Family Research Fund (Dr. Chari); the Prokopanko family gift to the Mayo Foundation (Drs. Chari and Sharma); and the Pancreatic Cancer Action Network (Drs. Chari and Maitra).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-2336.Corresponding Author: Suresh T. Chari, MD, Department of Gastroenterology, Hepatology and Nutrition, Unit 1466, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX 77030; e-mail, [email protected]org.Current Author Addresses: Dr. Chari: Department of Gastroenterology, Hepatology and Nutrition, Unit 1466, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX 77030.Dr. Sharma: Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.Dr. Maitra: Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030.Author Contributions: Conception and design: S.T. Chari, A. Sharma, A. Maitra.Drafting of the article: S.T. Chari, A. Sharma, A. Maitra.Critical revision of the article for important intellectual content: S.T. Chari, A. Sharma.Final approval of the article: S.T. Chari, A. Sharma, A. Maitra.This article was published at Annals.org on 17 March 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byE3 ubiquitin ligase TRIM29 promotes pancreatic cancer growth and progression via stabilizing Yes-associated protein 1 21 April 2020Volume 172, Issue 8Page: 558-559KeywordsAdenocarcinomaCancer detection and diagnosisComputed axial tomographyDisclosureGastroenterology and hepatologyGlucoseLung and intrathoracic tumorsNutritionPancreatic cancerProspective studies ePublished: 17 March 2020 Issue Published: 21 April 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...