From the Journals

USPSTF reaffirms recommendation against pancreatic cancer screening in asymptomatic adults


 

FROM JAMA

The U.S. Preventive Services Task Force has issued a recommendation statement reaffirming its 2004 guideline, which recommended against screening for pancreatic cancer in asymptomatic adults, according to task force member Douglas K. Owens, MD, of the Veterans Affairs Palo Alto (Calif.) Health Care System and associates.

Pancreatic cancer is uncommon, with an age-adjusted annual incidence of 12.9 cases per 100,000 person-years; however, pancreatic cancer is the third most common cause of cancer death because mortality is high. The mortality rate is 11.0 deaths per 100,000 person-years, and an estimated 45,750 people will die from the disease in 2019.

In 2004, the USPSTF issued a D recommendation for pancreatic cancer screening in asymptomatic adults without a family history of pancreatic cancer or a genetic disorder that increases the risk of cancer. For the 2019 update, the task force conducted a systematic review of 13 studies that assessed the benefits and harms of screening for pancreatic cancer, the diagnostic accuracy of screening tests for pancreatic cancer, and the benefits and harms of treating screen-detected or asymptomatic pancreatic cancer.

According to the USPSTF, the studies included in the review found no evidence that screening for pancreatic cancer or treatment of screen-detected pancreatic cancer improves morbidity or mortality, found adequate evidence that the magnitude of the benefits of screening for pancreatic cancer in asymptomatic adults can be bounded as no greater than small, and found adequate evidence that the magnitude of the harms of screening for pancreatic cancer and treatment of screen-detected pancreatic cancer can be bounded as at least moderate.

Because no new evidence was found supporting pancreatic cancer screening in asymptomatic adults, “the USPSTF reaffirms its previous conclusion that the potential benefits of screening for pancreatic cancer in asymptomatic adults do not outweigh the potential harms,” the task force members noted.

The task force authors reported no disclosures related to the recommendation statement.

SOURCE: Owens DK et al. JAMA. 2019 Aug 6. doi: 10.1001/jama.2019.10232.

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