Is Health Screening Benefi cial for Early Detection and Prognostic Improvement in Pancreatic Cancer?
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Background/Aims: The aim of this study was to evaluate the usefulness of health screening for early detection and improved prognosis in pancreatic cancer. Methods: Between 1995 and 2008, 176,361 examinees visited the Health Promotion Center (HPC). Twenty patients diagnosed with pancreatic cancer were enrolled. During the same period, 40patients were randomly selected from 2,202 patients diagnosed with pancreatic cancer at the Out Patient Clinic (OPC)for comparison. Results: Within the HPC group, 10 patients were initially suspected of having pancreatic cancer following abnormal ultrasonographic fi ndings, and 9 patients had suspected cases following the detection of elevated serum CA 19-9. The curative resection rate was higher in the HPC group than in the OPC group (p=0.011). The median survival was longer in the HPC group than in the OPC group (p=0.000). However, there was no significant difference in the 3-year survival rate between the two groups. Asymptomatic patients (n=6/20) in the HPC group showed better curative resection and survival rates than symptomatic patients. However,the difference was not statistically signifi cant. Conclusions:Health screening is somewhat helpful for improving the curative resection rate and median survival of patients with pancreatic cancer detected by screening tests. However, the benefi t of this method in improving long-term survival is limited by how early the cancer is detected.
Abstract
Background/Aims: The aim of this study was to evaluate the usefulness of health screening for early detection and improved prognosis in pancreatic cancer. Methods: Between 1995 and 2008, 176,361 examinees visited the Health Promotion Center (HPC). Twenty patients diagnosed with pancreatic cancer were enrolled. During the same period, 40patients were randomly selected from 2,202 patients diagnosed with pancreatic cancer at the Out Patient Clinic (OPC)for comparison. Results: Within the HPC group, 10 patients were initially suspected of having pancreatic cancer following abnormal ultrasonographic fi ndings, and 9 patients had suspected cases following the detection of elevated serum CA 19-9. The curative resection rate was higher in the HPC group than in the OPC group (p=0.011). The median survival was longer in the HPC group than in the OPC group (p=0.000). However, there was no significant difference in the 3-year survival rate between the two groups. Asymptomatic patients (n=6/20) in the HPC group showed better curative resection and survival rates than symptomatic patients. However,the difference was not statistically signifi cant. Conclusions:Health screening is somewhat helpful for improving the curative resection rate and median survival of patients with pancreatic cancer detected by screening tests. However, the benefi t of this method in improving long-term survival is limited by how early the cancer is detected.
참고문헌 (22)
- Jemal A, "Cancer statistics, 2009", CA Cancer J Clin, 59, pp.225~249 (2009)
- Chang DK, "Biankin AV; NSW Pancreatic Cancer Network. Improving outcomes for operable pancreatic cancer: is access to safer surgery the problem", J Gastroenterol Hepatol, 23(7 Pt 1), pp.1036~1045 (2008)
- Chari ST, "Detecting early pancreatic cancer: problems and prospects", Semin Oncol, 34, pp.284~294 (2007)
- Klapman J, "Early detection of pancreatic cancer: why, who, and how to screen", Cancer Control, 15, pp.280~287 (2008)
- Neoptolemos JP, "A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer", N Engl J Med, 350, pp.1200~1210 (2004)
- Brand RE, "Advances in counselling and surveillance of patients at risk for pancreatic cancer", Gut, 56, pp.1460~1469 (2007)
- Del Villano BC, "Radioimmunometric assay for a monoclonal antibody-defined tumor marker, CA 19-9", Clin Chem, 29, pp.549~552 (1983)
- Larghi A, "Screening for pancreatic cancer in high-risk individuals: a call for endoscopic ultrasound", Clin Cancer Res, 15, pp.1907~1914 (2009)
- Sohn TA, "Resected adenocarcinoma of the pancreas-616 patients: results, outcomes, and prognostic indicators", J Gastrointest Surg, 4, pp.567~579 (2000)
- Ariyama J, "The detection and prognosis of small pancreatic carcinoma", Int J Pancreatol, 7, pp.37~47 (1990)
- Kern S, "A white paper: the product of a pancreas cancer think tank", Cancer Res, 61, pp.4923~4932 (2001)
- Vitone LJ, "The inherited genetics of pancreatic cancer and prospects for secondary screening", Best Pract Res Clin Gastroenterol, 20, pp.253~283 (2006)
- Canto MI, "Strategies for screening for pancreatic adenocarcinoma in high-risk patients", Semin Oncol, 34, pp.295~302 (2007)
- Gullo L, "Do early symptoms of pancreatic cancer exist that can allow an earlier diagnosis", Pancreas, 22, pp.210~213 (2001)
- Kim BJ, "How do we interpret an elevated carbohydrate antigen 19-9 level in asymptomatic subjects", Dig Liver Dis, 41, pp.364~369 (2009)
- Kim JE, "Clinical usefulness of carbohydrate antigen 19-9 as a screening test for pancreatic cancer in an asymptomatic population", J Gastroenterol Hepatol, 19, pp.182~186 (2004)
- 이종균, "췌장암의 스크리닝 및 진단", 대한소화기학회지, 51(2), pp.84~88 (2008), 대한소화기학회
- Boeck S, "Prognostic and therapeutic significance of carbohydrate antigen 19-9 as tumor marker in patients with pancreatic cancer", Oncology, 70, pp.255~264 (2006)
- Helmstaedter L, "Pancreatic cancer: EUS and early diagnosis", Langenbecks Arch Surg, 393, pp.923~927 (2008)
- "American Gastroenterological Association medical position statement: epidemiology, diagnosis, and treatment of pancreatic ductal adenocarcinoma", Gastroenterology, 177, pp.1463~1484 (1999)
- Holly EA, "Signs and symptoms of pancreatic cancer: a population-based case-control study in the San Francisco Bay area", Clin Gastroenterol Hepatol, 2, pp.510~517 (2004)
- Khorana AA, "Pancreatic cancer and thromboembolic disease", Lancet Oncol, 5, pp.655~663 (2004)