Screening for pancreatic cancer
What is cancer screening?
Cancer screening looks for early signs of cancer in healthy people who don't have any symptoms. The aim is to help to pick up cancers early, which means treatment may be more successful and the chances of surviving cancer may be better. There is no official pancreatic cancer screening programme in the UK. But people who have a family history of pancreatic cancer might be able to have screening through a research study.
What are the benefits and disadvantages of screening?
All cancer screening programmes have disadvantages as well as benefits.
- Screening may find changes early, before they develop into cancer
- Screening may find cancer early before someone has any symptoms, when treatment may be more successful
- Screening can help people make more informed decisions about their health.
- Sometimes screening tests can miss a problem and this is called a false negative. This may mean people are wrongly reassured and ignore symptoms in the future
- Screening tests may sometimes suggest someone has cancer when they don't. This is known as a false positive. This can cause anxiety and may mean that people have more unnecessary tests or treatment
- If your screening test shows that you don't have a disease, this doesn't mean that you won't develop it in the future.
What cancer screening programmes are there in the UK?
In the UK, the NHS currently runs screening programmes for breast, cervical and bowel cancer.
There is screening for these cancers because they meet some specific conditions.
- They are relatively common, so affect large numbers of people
- There are tests for these cancers that are simple, safe and accurate
- There are effective treatments for these cancers, and early treatment is more likely to be successful
- The benefits of these screening programmes are greater than the possible risks.
Why isn't there screening for pancreatic cancer?
At the moment there is no programme in the UK to screen the general population for pancreatic cancer.
The main reason is that there isn't a suitable test for pancreatic cancer. A suitable test must be reliable and accurate enough so that it:
- Finds a large number of pancreatic cancers at an early stage
- Does not show that someone has pancreatic cancer when they don't (a false positive).
Is there any research into pancreatic cancer screening?
Although there is no official screening programme, there is research into screening for pancreatic cancer. Researchers are focusing on developing effective ways to screen people who have a higher risk of pancreatic cancer.
Who is at higher risk of pancreatic cancer?
Some people may have a higher risk of pancreatic cancer because they have a family history of it, for example, they have two or more first degree relatives (parent, brother, sister or child) with pancreatic cancer. For certain people in this situation screening may be available through the European Registry of Hereditary Pancreatitis and Familial Pancreatic Cancer (EUROPAC) research study. This secondary screening study is trying to find out the best way to screen people with a family history of pancreatic cancer.
Other risk factors
Some people may have a higher risk of pancreatic cancer because of other risk factors, for example, people who have recently been diagnosed with diabetes, and people with hereditary pancreatitis. Researchers are looking at screening people who are at higher risk.
What sort of screening tests are being developed?
Two main areas of research into screening for people at higher risk are biomarkers and scans.
Biomarkers are substances found in blood, body fluids or tissues, which can be signs of disease. They can be measured with a simple test to check someoneís health, or how well treatment is working. For example, CA19-9 is a biomarker that can be used, along with other tests, to help diagnose pancreatic cancer. However, not all pancreatic cancers produce CA19-9, and some other conditions that arenít cancerous can also produce it. This means that testing for CA19-9 isnít a good enough test to screen for pancreatic cancer. Researchers are looking at other possible biomarkers that would be more suitable for screening.
Scans are tests that make detailed pictures of areas inside the body. Different types of scans are already used to help diagnose pancreatic cancer.
Researchers are looking at using scans to find areas of abnormal tissue before they become cancerous, or to find cancers that are too small to cause symptoms yet. They are comparing different types of scan, to see which would be best for this screening, including:
- MRI scans (magnetic resonance imaging)
- EUS (endoscopic ultrasound)
- CT scans (computerised tomography).
CT scans use radiation. Having regular CT scans may slightly increase your risk of cancer, although the risk of this is small.
Updated January 2016
To be reviewed January 2018