Asymptomatic individuals at high risk for pancreatic cancer may have pancreatic cysts and benefit from screening, according to recent results.
Researchers evaluated 225 patients in a prospective cohort study across five medical centers throughout the US. Participants were between ages 30 and 80 and at high risk for pancreatic cancer but asymptomatic, and underwent CT, MRI and endoscopic ultrasonography (EUS) tests to determine the presence of pancreatic masses.
Among 216 evaluable participants, the tests revealed pancreatic masses or a dilated pancreatic duct in 92 (42%) patients. EUS tests detected the most abnormalities (42.6%) compared to 33.3% through MRI and 11% from CT tests. Reported lesions included 84 cystic and three solid masses, with 51 of participants with a cyst (60.7%) having multiple lesions in various locations. The remaining five participants (2.3%) had dilated pancreatic ducts without masses. Neoplasms were proven or suspected in 85 of the abnormalities, including 82 intraductal papillary mucious neoplasms and three pancreatic endocrine tumors.
Advanced age increased the likelihood of pancreatic masses: 14% of patients aged younger than 50 years had lesions compared to 34% of patients between 50 and 59 years and 53% of participants between 60 and 69 years (P<.0001).
“Pancreatic cysts can be found in asymptomatic individuals in the general population, [in greater numbers] with increasing age,” said researcher Marcia Irene Canto, MD, MHS, “similar perhaps to how precancerous colon polyps are common and increase with age. More and more people are being diagnosed with these incidentally-found cysts in the pancreas. [It is a] very challenging clinical conundrum.”
The researchers suggested that a pancreatic cancer screening and surveillance program focused on precursor neoplasms rather than invasive cancers could lead to early detection and prevention of the illness among asymptomatic patients.