Pancreatic Cancer

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Thankfully, pancreatic cancer is an uncommon cancer, yet it is the third most common cause of cancer deaths in the United States. That is because it is usually detected after it has spread. The age-adjusted annual incidence is 12.9 cases per 100,000 person-years, however the death rate is 11 deaths per 100,000 person-years. In other words, the prognosis, once it is diagnosed, is poor. Based on a study that ran from 2009 to 2015, the overall five-year survival rate for pancreatic cancer is 9.3 percent. The survival rate depends on the stage at which it is discovered. The five-year survival rate for localized disease is 37.4 percent. When regional disease is diagnosed (localized spread only), the five-year survival rate drops to 12.4 percent, and when distant metastatic disease (spread) is found, the rate drops to 2.9 percent. Only five to 10 percent of cases have familiar or genetic risk factors, for example the BReast CAncer gene (BRCA).

Unlike many, if not most other cancers, there is no specific test to detect pancreatic cancer. Leukemias, lymphomas, and multiple myeloma can be detected with a blood test. Lung cancers with a chest X-ray, colon cancer with colonoscopy, et cetera. Recently, the United States Preventive Services Task Force (USPSTF), which looks at ways of screening for and detecting diseases including cancers, studied detection methods for pancreatic cancer. They determined that screening for pancreatic cancer and treatment of screen-detected pancreatic cancers did not improve morbidity (illness) or death from the disease. Therefore, they recommended not screening for it, except in cases where there is a family history of it, or a known gene mutation associated with it. Risk factors for pancreatic cancer include diabetes, older age, cigarette smoking, obesity, and a history of chronic pancreatitis.

Screening for pancreatic cancer is done using imaging technologies like CT scans, MRIs, and endoscopic ultrasound. Abdominal sonograms are usually not helpful in screening because the stomach and bowel overlie the pancreas making visualizing it difficult. There are currently no accurate, validated biomarkers (blood tests) for early detection of pancreatic cancer. Because mass screening of the general population with CT scans and MRIs would yield little in the way of results and would greatly increase healthcare costs (most insurance companies would not authorize them anyway) and would not alter the survival rates, the USPSTF recommends against general screening for pancreatic cancer.

It is estimated that in 2019, 56,770 persons will be diagnosed with pancreatic cancer and 45,750 persons will die of the disease. If you or a family member has a strong family history of pancreatic cancer (meaning two or more first-degree relatives [parents, brothers, sisters, or children] who have had pancreatic cancer) or you or your family has genetic mutations (i.e. BRCA, Peutz-Jeghers syndrome), you should see your doctor and be screened for the disease.

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