Comparative cohort study of survival of surveillance-detected PDAC versus PDAC patients in the general population

The Cancer of the Pancreas Screening program in multiple US academic medical centers screens high-risk individuals with genetic predisposition for PDAC, using annual endoscopic ultrasonography or magnetic resonance imaging. A cohort study compared 26 PDAC-patients detected in the program with matched control PDAC patients in the SEER database. The median primary tumor diameter in the screened patients was smaller than in the control patients (2.5 versus 3.6 cm; p<0.001). The screened patients were more likely to be diagnosed with a lower stage than the control patients. The PDAC mortality rate at 5 years was 43% in the screened patients versus 86% in the control patients (HR 3.58; p<0.001). The median overall survival after diagnosis was 61.7 months in the screened patients versus 8.0 months in the control patients, with 5-year OS rate 50% versus 9%. The authors conclude that surveillance of high-risk individuals may lead to detection of smaller, lower-stage PDACs and improved survival.