췌장암 고위험군에서 빈번한 감시 검사를 하면 치료 가능한 췌장암 조기 발견이 가능하다.

1. Clinical Gastroenterology and Hepatology VOLUME 20, ISSUE 9, P1927-1930, SEPTEMBER 202

★내용 중에서...

조사자들은 50세 이후 새롭게 진단된 당뇨병과 췌장암 사이의 강한 관련성을 발견습니다.

50세 이후 당뇨병이 발생한 환자에서 당뇨병 이후 3년 췌장암 발생률은 0.8-1.0%로 일반 인구의 6-10배 더 높았습니다. 이러한 발견은 USPSTF로 하여금 50세 이후 새롭게 진단된 당뇨병 환자를 sporadic pancreatic cancer의 고위험군으로 인식하도록 만들었습니다...

아직 고위험군이 아닌 경우 USPSTF는 일상적 검ㅅ를 권고하지 않습니다.

 

2. UpToDate 2023.02.11 - 위험인자가 없는 경우 새롭게 진단된 당뇨병 환자에서 감시 검사가 필요하지 않습니다.

① Nonfamilial risk factors for exocrine pancreatic cancer : UpToDate 2023.02.11

Thus, screening for pancreatic cancer is not warranted in older, otherwise asymptomatic adults with new-onset atypical diabetes. This recommendation is consistent with guidelines from the United States Preventive Services Task Force, which specifically recommend against screening for pancreatic cancer in asymptomatic adults not known to be at high risk because of family history or inherited genetic syndromes, including those with preexisting or new-onset diabetes.

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② Familial risk factors for pancreatic cancer - 위험인자가 있는 경우 감시 검사가 권고됩니다.

As new onset of diabetes may be indicative of an underlying pancreatic neoplasm in a high-risk individual, we perform urgent imaging (within two weeks) with EUS/MRCP/pancreatic protocol CT scan in such patients to evaluate the pancreas.

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Pancreatic cancer surveillance in high-risk individuals (August 2022)

While surveillance for pancreatic cancer in high-risk individuals (HRIs) is recommended by expert groups, the long-term benefits have not been clearly established. In an analysis of 1,731 HRIs enrolled in the multicenter Cancer of Pancreas Screening (CAPS) study, 26 invasive cancers were diagnosed over a >20 year period; cases detected during surveillance were more likely to be early stage and associated with longer survival. In a separate cohort study of 347 carriers of a pathogenic variant in CDKN2A who participated in a longitudinal surveillance protocol and were followed for approximately six years, 30 of the 36 pancreatic cancers detected were resectable at diagnosis; 12 were stage I. Five-year survival was 32 percent in the entire cohort but among the six individuals with stage I tumors who underwent resection, five (83 percent) remained alive at three years. These studies demonstrate that early detection of potentially curable pancreatic cancer in HRIs is possible with frequent image-based surveillance, and that the numbers needed to test to detect a single case of pancreatic cancer are reasonable (194 HRIs in the CAPS analysis and 70 in CDKN2A carriers)

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참고 블로그 https://blog.naver.com/sjloveu2/223012594742

Genetic susceptibility가 있는 사람에서 췌장암 감시 검사 : ASGE 가이드라인 2022

 

 

2023.02.11 UpToDate

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