CA 19-9, Ultrasound Feasible for Pancreatic Cancer Detection

Protocol feasible for detecting early stage pancreatic adenocarcinoma in high-risk patients

MONDAY, Aug. 1 (HealthDay News) -- Screening for tumor marker CA 19-9 followed by targeted endoscopic ultrasound (EUS) when the level is elevated represents a feasible approach for identifying early pancreatic adenocarcinoma in a high-risk population, according to a study published in the July issue of Gastrointestinal Endoscopy.

Richard Zubarik, M.D., from the University of Vermont in Burlington, and colleagues investigated whether screening for serum CA 19-9 followed by targeted EUS can detect early pancreatic neoplasia in 546 patients with at least one first-degree relative diagnosed with pancreatic adenocarcinoma. Fine needle aspiration of lesions was carried out. Patients whose pancreatic cancer was detected by this screening protocol were compared to patients who did not participate in the protocol for staging data. Detection of early pancreatic neoplasia was the main outcome measure. Medicare reimbursement rates were used to calculate cost data.

The investigators identified 27 patients with elevated CA 19-9, five patients with neoplastic or malignant findings, and one patient with pancreatic adenocarcinoma. The patient whose pancreatic cancer was discovered as part of this study was one of two patients at the University of Vermont with stage 1 cancer. The cost to detect one pancreatic neoplasia and one pancreatic adenocarcinoma was $8,431 and $41,133, respectively.

"Potentially curative pancreatic adenocarcinoma can be identified with this screening protocol. Stage 1 pancreatic cancer is more likely to be detected by using this screening protocol than by using standard means of detection," the authors write.

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