51. Screening/surveillance programs for pancreatic cancer in familial high-risk individuals: A systematic review and proportion meta-analysis of screening results
- Author
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Salvatore Paiella, Davide Melisi, Stefano Andrianello, Roberto Salvia, Luca Casetti, Mirko D'Onofrio, Laura Maggino, Giuseppe Malleo, Deborah Bonamini, Alessandro Esposito, Giulia De Marchi, Claudio Bassi, Luca Landoni, Massimiliano Tuveri, Tommaso Pollini, Riccardo De Robertis, Matteo De Pastena, Aldo Scarpa, Erica Secchettin, Giovanni Marchegiani, and Teresa Lucia Pan
- Subjects
Risk ,Pediatrics ,medicine.medical_specialty ,surveillance program ,Endocrinology, Diabetes and Metabolism ,pancreatic cancer ,MEDLINE ,familial pancreatic cancer ,Cochrane Library ,screening program ,03 medical and health sciences ,0302 clinical medicine ,Pancreatic cancer ,medicine ,Humans ,Early Detection of Cancer ,Hepatology ,Intraductal papillary mucinous neoplasm ,business.industry ,Gastroenterology ,medicine.disease ,Random effects model ,diagnostic yield ,Pancreatic Neoplasms ,Treatment Outcome ,Dysplasia ,030220 oncology & carcinogenesis ,Meta-analysis ,Cohort ,030211 gastroenterology & hepatology ,business - Abstract
Background/Objectives Screening/surveillance programs for pancreatic cancer (PC) in familial high-risk individuals (FPC-HRI) have been widely reported, but their merits remain unclear. The data reported so far are heterogeneous—especially in terms of screening yield. We performed a systematic review and meta-analysis of currently available data coming from screening/surveillance programs to evaluate the proportion of screening goal achievement (SGA), overall surgery and unnecessary surgery. Methods We searched MEDLINE, Embase, PubMed and the Cochrane Library database from January 2000 to December 2016to identify studies reporting results of screening/surveillance programs including cohorts of FPC-HRI. The main outcome measures were weighted proportion of SGA, overall surgery, and unnecessary surgery among the FPC-HRI cohort, using a random effects model. SGA was defined as any diagnosis of resectable PC, PanIN3, or high-grade dysplasia intraductal papillary mucinous neoplasm (HGD-IPMN). Unnecessary surgery was defined as any other final pathology. Results In a meta-analysis of 16 studies reporting on 1551 FPC-HRI cases, 30 subjects (1.82%), received a diagnosis of PC, PanIN3 or HGD-IPMNs. The pooled proportion of SGA was 1.4%(95% CI 0.8–2, p Conclusions The weighted proportion of SGA of screening/surveillance programs published thus far is excellent. However, the probability of receiving surgery during the screening/surveillance program is non-negligible, and unnecessary surgery is a potential negative outcome.
- Published
- 2018