What is it about?

Our pilot study showed that such a high-risk sub-population was identifiable within the general population up to 20 months prior to pancreatic cancer diagnosis with a sensitivity approaching 70%. However, it has been conducted on a relatively small sample of pancreatic cancer cases and used other-cancer patient as controls.

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Why is it important?

Pancreatic cancer (PC) is rarely detected in its early stages, and therefore is one of the tumours with the lowest survival. Progress to diagnose it early, when the tumour is localised to pancreas and still treatable, has been extremely slow. Although several years may elapse between the biological initiation of PC and its clinical presentation (usually at an advanced stage), many patients display no specific alarm symptoms for most of this time. Introduction of a mass-population based screening for PC is prohibitively expensive and even potentially damaging due to the low disease incidence. Targeted screening is an alternative option. Using protein markers either alone or in combination with one clinically established biomarker, CA 19-9, have revealed promising results. The authors of these molecular studies mostly identify their application to high-risk groups containing small numbers of people. Alternatively, such tests might be applied more widely if a suitable high-risk subgroup of the general population could be identified.

Perspectives

Using electronic health records from primary care in the UK, we are now conducting a case-control study, using population-based controls, to assess its performance ‘on the ground’ and evaluate its economic impact in combination with the most accurate biomarker tests available to date.

Ananya Malhotra
London School of Hygiene & Tropical Medicine

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This page is a summary of: Can we screen for pancreatic cancer? Identifying a sub-population of patients at high risk of subsequent diagnosis using machine learning techniques applied to primary care data, PLoS ONE, June 2021, PLOS,
DOI: 10.1371/journal.pone.0251876.
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