Results of surveillance in individuals at high-risk of pancreatic cancer: A systematic review and meta-analysis
Background: Data on surveillance for pancreatic ductal adenocarcinoma (PDAC) in high-risk individuals (HRIs) with “familial pancreatic cancer” (FPC) and specific syndromes are limited and heterogeneous. Objective: We conducted a systematic review and meta-analysis of PDAC surveillance studies in HRIs. Methods: Prevalence of solid/cystic pancreatic lesions and of lesions considered a successful target of surveillance (proven resectable PDAC and high-grade precursors) was pooled across studies. The rate of lesions diagnosed by endoscopic ultrasonography (EUS)/magnetic resonance imaging (MRI) and across different HRI groups was calculated. Results: Sixteen studies incorporating 1588 HRIs were included. The pooled prevalence of pancreatic solid and cystic lesions was 5.8% and 20.2%, respectively. The pooled prevalence of patients with lesions considered a successful target of surveillance was 3.3%, being similar to EUS or MRI and varying across subgroups, being 3% in FPC, 4% in hereditary pancreatitis, 5% in familial melanoma, 6.3% in hereditary breast/ovarian cancer, and 12.2% in Peutz-Jeghers syndrome. The pooled estimated rate of lesions considered a successful target of surveillance during follow-up was 5/1000 person-years. Conclusion: Surveillance programs identify successful target lesions in 3.3% of HRIs with a similar yield of EUS and MRI and an annual risk of 0.5%. A higher rate of target lesions was reported in HRIs with specific DNA mutations.
|Keywords||family history, meta-analysis, Pancreatic cancer, screening|
|Persistent URL||dx.doi.org/10.1177/2050640617752182, hdl.handle.net/1765/106436|
|Journal||United European Gastroenterology Journal|
Signoretti, M, Bruno, M.J, Zerboni, G. (Giulia), Poley, J.-W, Delle Fave, G, & Capurso, G. (Gabriele). (2018). Results of surveillance in individuals at high-risk of pancreatic cancer: A systematic review and meta-analysis. United European Gastroenterology Journal (Vol. 6, pp. 489–499). doi:10.1177/2050640617752182