Neoplasms

Digestive System Diseases

Gland and Hormone Related Diseases

All Conditions

Symptoms and General Pathology

Diseases and Abnormalities at or Before Birth

Rare Diseases

Pancreatic Neoplasms

Adenocarcinoma

Pancreatitis

Pancreatitis, Chronic

Genetic Diseases, Inborn

Carcinoma

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Gastrointestinal Diseases

Pancreatic Diseases

Chronic Disease

Disease Attributes

Chronic Graft Versus Host Disease

Pancreatic Cancer

Anti-Infective Agents

All Drugs and Chemicals

Carbamide Peroxide

Bilirubin

Chronic pancreatitis, due to cystic fibrosis

Persons with a confirmed diagnosis of Peutz-Jeghers syndrome (STK11 mutation) or familial melanoma syndrome (CDKN2A mutation), hereditary pancreatitis (PRSS1 mutation)

Persons with a confirmed diagnosis of hereditary syndromes and at the same time with the condition of at least one relative of the first or second degree with a diagnosis of pancreatic ductal adenocarcinoma in family anamnesis; i.e. Lynch syndrome (mut: MLH1, MSH2, MSH6 a PMS2, EPCAM), HBOC (mut: BRCA1, BRCA2, PALB2, ATM), familial adenomatous polyposis (mut: APC), Li-Fraumeni syndrome (mut: TP53)

Persons with positive family anamnesis of pancreatic ductal adenocarcinoma without proven hereditary syndrome

endoscopic ultrasonography - frequency defined by arm

endoscopic ultrasonography

magnetic resonance - frequency defined by arm

magnetic resonance

hematology, biochemistry, Na+, K+, Cl-, Ca2+, bilirubin, ALT, AST, GGT, ALP, lactate dehydrogenase, creatinine, urea, fasting glycemia, HbA1c, alpha-amylase, LPS, albumin, total protein, CA19-9, CEA

laboratory examination

Martina Lojova, Ph.D.

Dita Kozakova, Ing.

Petr Karasek, MD

Jana Halamkova, MD

Helena Coupkova, MD

Anna Ondrackova, MD

Marketa Palacova, MD

Radim Nemecek, MD

Lumir Kunovsky, MD

Jan Trna, MD

Lenka Foretova, MD

Zdenka Cermakova, MD

Jan Kristek, MD

Roman Hrstka, Ph.D.

Pancreatic cancer is one of the diseases with the worst prognosis, which is mainly due to the initial asymptomatic prognosis. Unfortunately, the incidence of this disease in the Czech Republic is still increasing. In a certain proportion of patients, it is possible to predict the disease, e.g. due to family burdens. Regular follow-up of such individuals is the subject of the SCREPAN study: "Pancreatic Cancer Screening in High-Risk Persons".

Pancreatic ductal adenocarcinoma (PDAC) is one of the cancers with the worst prognosis. Mortality in this disease is almost equal to the incidence. In the Czech Republic, the incidence of this cancer has an upward trend, in 2017, 21.2 new cases per 100,000 people were reported, which represents a more than double increase compared to the data from the 1970s.

Pancreatic cancer is associated with an extremely poor prognosis for several reasons. It is usually diagnosed at an advanced stage, which is often due to the asymptomatic course of the disease or non-specific symptoms, the lack of sensitive and specific tumor markers, and difficult diagnosis by imaging methods in the early stages. Five-year survival, regardless of clinical stage, is between 7-9%.

Resectable disease is diagnosed in only 10% of patients, in which the 5-year survival rate is 37 %, locally advanced unresectable disease is detected in about 30 % of patients with a 5-year survival of 12 %, and metastatic disease is found in about 60 % of patients, with a 5-year survival rate of only around 3 %.

The poor prognosis of this disease is also due to the limited possibilities of screening and curative intervention for a short "lead time" in rapidly metastatic disease.

Pancreatic cancer screening is not suitable for the non-selected population. On the contrary, it is important for individuals with a high risk of developing this disease. In these subjects, early diagnosis during screening demonstrated a higher number of curative resections and longer survival.

Pancreatic Cancer Screening in a Population at High Risk

Number of participants (in risk population) with newly diagnosed pancreatic cancer

Comparison of magnetic resonance versus endoscopic ultrasonography yield

Comparison of magnetic resonance versus endoscopic ultrasonography cost effectiveness

KRAS mutation status defined by number of positive droplets on drop digital PCR using material from liquid biopsy

Spots Global Cancer Trial Database for screening programme