National Center for Health Research; March 4, 2019
National Center for Health Research’s Public Comments on
the USPSTF’s Draft Recommendation Statement on Pancreatic Cancer: Screening
Thank you for the opportunity to share our views regarding the U.S. Preventive Services Task Force’s (USPSTF) draft recommendation against pancreatic cancer screening in asymptomatic adults. The National Center for Health Research is a nonprofit research center that analyzes and reviews research on a range of health issues, with particular focus on which treatment and prevention strategies are most effective for which patients and consumers. We do not accept funding from companies that make products that are the subject of our work.
We agree with the “D” grade recommendation against pancreatic cancer screening in asymptomatic adults.
As discussed in the recommendation and review, pancreatic cancer is uncommon with an estimated age-adjusted annual incidence of 12.6 cases per 100,000 person-years and has a poor prognosis due to ineffective treatment options with an overall 5-year survival rate of 8.5%. There is no evidence that screening for pancreatic cancer or treatment of screen-detected pancreatic cancer improves patient outcomes, including disease-specific morbidity or mortality, or all-cause mortality. We agree that, “Based on the low incidence of pancreatic cancer in the general population, the uncertain accuracy of current candidate screening tests, and the poor prognosis for pancreatic cancer even when treated at an early stage, the USPSTF found adequate evidence to bound the benefits of screening for pancreatic cancer in asymptomatic adults as no greater than small.”
Data also indicate that screening asymptomatic adults may lead to overdiagnosis through false-positive results and thus overtreatment, such as invasive surgeries. In addition, current screening methods pose their own risks, including exposure to radiation and endoscopic ultrasonography postprocedural pain.
In conclusion, we support the USPSTF’s draft recommendation against screening for pancreatic cancer in asymptomatic adults because screening asymptomatic adults does not improve patient outcomes and poses its own risks.
Thank you for the opportunity to comment on this important issue.
The National Center for Health Research can be reached through Stephanie Fox-Rawlings, PhD at firstname.lastname@example.org.
- Draft Recommendation Statement: Pancreatic Cancer: Screening. U.S. Preventive Services Task Force. February 2019. https://www.uspreventiveservicestaskforce.org/Page/Document/draft-recommendation-statement/pancreatic-cancer-screening1