Research output: Contribution to journal › Article › Academic › peer-review
Timeline of Development of Pancreatic Cancer and Implications for Successful Early Detection in High-Risk Individuals. / International Cancer of the Pancreas Screening Consortium.
In: Gastroenterology, Vol. 162, No. 3, 01.03.2022, p. 772-785.e4.Research output: Contribution to journal › Article › Academic › peer-review
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TY - JOUR
T1 - Timeline of Development of Pancreatic Cancer and Implications for Successful Early Detection in High-Risk Individuals
AU - Overbeek, Kasper A.
AU - Goggins, Michael G.
AU - Dbouk, Mohamad
AU - Levink, Iris J. M.
AU - Koopmann, Brechtje D. M.
AU - Chuidian, Miguel
AU - Konings, Ingrid C. A. W.
AU - Paiella, Salvatore
AU - Earl, Julie
AU - Fockens, Paul
AU - Gress, Thomas M.
AU - Ausems, Margreet G. E. M.
AU - Poley, Jan-Werner
AU - Thosani, Nirav C.
AU - Half, Elizabeth
AU - Lachter, Jesse
AU - Stoffel, Elena M.
AU - Kwon, Richard S.
AU - Stoita, Alina
AU - Kastrinos, Fay
AU - Lucas, Aimee L.
AU - Syngal, Sapna
AU - Brand, Randall E.
AU - Chak, Amitabh
AU - Carrato, Alfredo
AU - Vleggaar, Frank P.
AU - Bartsch, Detlef K.
AU - International Cancer of the Pancreas Screening Consortium
AU - van Hooft, Jeanin E.
AU - Cahen, Djuna L.
AU - Canto, Marcia Irene
AU - Bruno, Marco J.
N1 - Funding Information: The authors acknowledge all collaborators in the CAPS consortium, 9 Knots Business Solutions for the development and maintenance of the online database system, and the research coordinators who have assisted in data collection in their respective centers: Tara Dhingra, Patil Prithvi, Anne Aronson, Chinedu Ukaegbu, Erika Koeppe, Georgia Castrigano, and Nancy Furey. Kasper A. Overbeek, MD (Conceptualization: Supporting; Data curation: Lead; Formal analysis: Lead; Investigation: Supporting; Methodology: Supporting; Project administration: Lead; Writing – original draft: Lead; Writing – review & editing: Supporting). Michael G. Goggins, MD (Conceptualization: Supporting; Funding acquisition: Supporting; Methodology: Supporting; Supervision: Equal; Writing – review & editing: Equal). Mohamad Dbouk, MD (Data curation: Equal; Project administration: Supporting; Writing – review & editing: Supporting). Iris J.M. Levink, MD (Data curation: Supporting; Investigation: Supporting; administration: Supporting; Writing – review & editing: Supporting). Brechtje D.M. Koopmann, MD (Data curation: Supporting; Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Miguel Chuidian, BSc (Data curation: Supporting). Ingrid C.A.W. Konings, MD, PhD (Data curation: Equal; Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Salvatore Paiella, MD, PhD (Data curation: Supporting; Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Julie Earl, MD, PhD (Data curation: Supporting; Writing – review & editing: Supporting). Paul Fockens, MD (Investigation: Equal; Supervision: Supporting; Writing – review & editing: Supporting). Thomas M. Gress, MD (Data curation: Supporting; Investigation: Supporting; Writing – review & editing: Supporting). Margreet G.E.M. Ausems, MD (Project administration: Supporting; Writing – review & editing: Supporting). Jan-Werner Poley, MD, PhD (Investigation: Equal; Writing – review & editing: Supporting). Nirav C. Thosani, MD, PhD (Data curation: Supporting; Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Elizabeth Half, MD, PhD (Data curation: Supporting; Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Jesse Lachter, MD (Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Elena M. Stoffel, MD, PhD (Data curation: Supporting; Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Richard S. Kwon, MD, PhD (Investigation: Supporting; Writing – review & editing: Supporting). Alina Stoita, MD, PhD (Data curation: Supporting; Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Fay Kastrinos, MD, PhD (Data curation: Supporting; Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Aimee L. Lucas, MD (Data curation: Supporting; Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Sapna Syngal, MD (Data curation: Supporting; Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Randall E. Brand, MD, PhD (Data curation: Supporting; Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Amitabh Chak, MD, PhD (Data curation: Supporting; Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Alfredo Carrato, MD (Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Frank P. Vleggaar, MD (Data curation: Supporting; Investigation: Equal; Project administration: Supporting; Supervision: Supporting; Writing – review & editing: Supporting). Detlef K. Bartsch, MD (Data curation: Supporting; Investigation: Supporting; Project administration: Supporting; Writing – review & editing: Supporting). Jeanin E. van Hooft, MD (Investigation: Equal; Supervision: Supporting; Writing – review & editing: Supporting). Djuna L. Cahen, MD (Conceptualization: Supporting; Formal analysis: Supporting; Methodology: Supporting; Supervision: Equal; Writing – original draft: Supporting; Writing – review & editing: Equal). Marcia Irene Canto, MD (Conceptualization: Equal; Funding acquisition: Supporting; Investigation: Equal; Methodology: Supporting; Project administration: Supporting; Supervision: Equal; Writing – review & editing: Equal). Marco J. Bruno, MD (Conceptualization: Lead; Funding acquisition: Lead; Investigation: Lead; Methodology: Lead; Project administration: Supporting; Supervision: Lead; Writing – review & editing: Lead). Conflicts of interest These authors disclose the following: Paul Fockens received research funding from Boston Scientific and is a consultant to Olympus, Cook Medical, and Ethicon Endo-Surgery. Jan-Werner Poley is a consultant to Boston Scientific, Cook Medical, and PENTAX Medical. Nirav C. Thosani is a consultant to PENTAS of America and Boston Scientific, a speaker for AbbVie, and receives royalties from UpToDate. Aimee L. Lucas has received research funding from Immunovia. Sapna Syngal has served as a consultant to Myriad Genetics. Randall E. Brand has received research funding from Immunovia and Freenome. Alfredo Carrato is a consultant to Bristol Myers Squibb and has received honoraria from Bayer, Shire, and Celgene. Frank P. Vleggaar is a consultant to Boston Scientific. Djuna L. Cahen is a consultant to Tramedico. Jeanin E. van Hooft received research funding from Abbott and Cook Medical and is a consultant to Boston Scientific, Cook Medical, Olympus, and Medtronic. Marcia Irene Canto received research funding from PENTAX Medical C2 CryoBalloon and EndoGastric Solutions. Marco J. Bruno received research funding from Boston Scientific, Cook Medical, and PENTAX Medical and is a consultant to Boston Scientific, Cook Medical, PENTAX Medical, and Mylan. The other authors disclose no conflicts. Funding No commercial financial support was received for the execution of this study. The study was partly funded by a charity donation from the Living with Hope Foundation. Funding Information: Funding No commercial financial support was received for the execution of this study. The study was partly funded by a charity donation from the Living with Hope Foundation. Publisher Copyright: © 2022 The Authors
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Background & Aims: To successfully implement imaging-based pancreatic cancer (PC) surveillance, understanding the timeline and morphologic features of neoplastic progression is key. We aimed to investigate the progression to neoplasia from serial prediagnostic pancreatic imaging tests in high-risk individuals and identify factors associated with successful early detection. Methods: We retrospectively examined the development of pancreatic abnormalities in high-risk individuals who were diagnosed with PC or underwent pancreatic surgery, or both, in 16 international surveillance programs. Results: Of 2552 high-risk individuals under surveillance, 28 (1%) developed neoplastic progression to PC or high-grade dysplasia during a median follow-up of 29 months after baseline (interquartile range [IQR], 40 months). Of these, 13 of 28 (46%) presented with a new lesion (median size, 15 mm; range 7–57 mm), a median of 11 months (IQR, 8; range 3–17 months) after a prior examination, by which time 10 of 13 (77%) had progressed beyond the pancreas. The remaining 15 of 28 (54%) had neoplastic progression in a previously detected lesion (12 originally cystic, 2 indeterminate, 1 solid), and 11 (73%) had PC progressed beyond the pancreas. The 12 patients with cysts had been monitored for 21 months (IQR, 15 months) and had a median growth of 5 mm/y (IQR, 8 mm/y). Successful early detection (as high-grade dysplasia or PC confined to the pancreas) was associated with resection of cystic lesions (vs solid or indeterminate lesions (odds ratio, 5.388; 95% confidence interval, 1.525–19.029) and small lesions (odds ratio, 0.890/mm; 95% confidence interval 0.812–0.976/mm). Conclusions: In nearly half of high-risk individuals developing high-grade dysplasia or PC, no prior lesions are detected by imaging, yet they present at an advanced stage. Progression can occur before the next scheduled annual examination. More sensitive diagnostic tools or a different management strategy for rapidly growing cysts are needed.
AB - Background & Aims: To successfully implement imaging-based pancreatic cancer (PC) surveillance, understanding the timeline and morphologic features of neoplastic progression is key. We aimed to investigate the progression to neoplasia from serial prediagnostic pancreatic imaging tests in high-risk individuals and identify factors associated with successful early detection. Methods: We retrospectively examined the development of pancreatic abnormalities in high-risk individuals who were diagnosed with PC or underwent pancreatic surgery, or both, in 16 international surveillance programs. Results: Of 2552 high-risk individuals under surveillance, 28 (1%) developed neoplastic progression to PC or high-grade dysplasia during a median follow-up of 29 months after baseline (interquartile range [IQR], 40 months). Of these, 13 of 28 (46%) presented with a new lesion (median size, 15 mm; range 7–57 mm), a median of 11 months (IQR, 8; range 3–17 months) after a prior examination, by which time 10 of 13 (77%) had progressed beyond the pancreas. The remaining 15 of 28 (54%) had neoplastic progression in a previously detected lesion (12 originally cystic, 2 indeterminate, 1 solid), and 11 (73%) had PC progressed beyond the pancreas. The 12 patients with cysts had been monitored for 21 months (IQR, 15 months) and had a median growth of 5 mm/y (IQR, 8 mm/y). Successful early detection (as high-grade dysplasia or PC confined to the pancreas) was associated with resection of cystic lesions (vs solid or indeterminate lesions (odds ratio, 5.388; 95% confidence interval, 1.525–19.029) and small lesions (odds ratio, 0.890/mm; 95% confidence interval 0.812–0.976/mm). Conclusions: In nearly half of high-risk individuals developing high-grade dysplasia or PC, no prior lesions are detected by imaging, yet they present at an advanced stage. Progression can occur before the next scheduled annual examination. More sensitive diagnostic tools or a different management strategy for rapidly growing cysts are needed.
KW - Familial Pancreatic Cancer
KW - Pancreatic Cancer
KW - Screening
KW - Surveillance
UR - http://www.scopus.com/inward/record.url?scp=85124581308&partnerID=8YFLogxK
U2 - 10.1053/j.gastro.2021.10.014
DO - 10.1053/j.gastro.2021.10.014
M3 - Article
C2 - 34678218
VL - 162
SP - 772-785.e4
JO - Gastroenterology
JF - Gastroenterology
SN - 0016-5085
IS - 3
ER -
ID: 24160509