Researchers detect early stage pancreatic cancer with tumour marker and Endoscopic ultrasound

A recent study from the University of Vermont, New England, and the Dartmouth-Hitchcock Medical Centre, has suggested that it may now be possible to diagnose pancreatic cancer more effectively at its earlier and more treatable stages.

By screening high risk patients with a combination of the tumour marker serum CA 19-9 and an endoscopic ultrasound, researchers now believe that the disease can be identified earlier and with greater accuracy than current methods of detection.

The majority of pancreatic cancer symptoms appear only when the tumour is locally advanced or metastatic, meaning late diagnosis is common and treatment becomes less effective. If, however, the disease is detected in its localised stage (stage 1), the survival rate increases as pancreatic surgery can then usually be performed.

The study, lead by Richard Zubarik, MD, and published in the July issue of Gastrointestinal Endoscopy, targeted high risk populations, specifically those over the age of 50 who had at least one first degree relative with pancreatic cancer. The age requirement was lowered to 45 if the patient had two first-degree relatives with the disease, and extended to 40 if the person had a BRCA2 mutation or Peutz-Jeghers syndrome. The study also included a comparison group of patients who were previously diagnosed with pancreatic cancer but were not originally involved with the study.

The results showed that of the 546 patients involved in the study, one patient was diagnosed with stage 1 pancreatic cancer. The disease was not detected in any additional patients in the one-year follow-up. In the comparison group, of the 124 patients only 0.9% had stage 1 pancreatic cancer, the rest having been diagnosed with the disease in its later stages.  This difference is statistically significant despite there being only one patient with pancreatic cancer detected in the study group because the detection of stage 1 cancer in the comparison group was so rare.

This new study has not yet been conclusively tested on lower risk populations below the age of 50 and with no obvious genetic predisposition to pancreatic cancer. However, it does show that the disease can be detected in its earliest stages among high risk patients using CA 19-9 and targeted endoscopic ultrasounds, which could potentially increase the survival rate of patients.