Lee Alice A, Twoy Abigail, Sutton Audrey, Fushimi Naoko, Park Walter G
Division of Gastroenterology and Hepatology, Stanford University, Stanford, CA, USA.
Division of Gastroenterology and Hepatology, Stanford University, Stanford, CA, USA.
Pancreatology. 2025 Jun;25(4):540-543. doi: 10.1016/j.pan.2025.05.002. Epub 2025 May 10.
BACKGROUND/OBJECTIVES: Screening for pancreatic ductal adenocarcinoma alters the course of disease among high-risk individuals (HRIs) and is recommended by multiple societies including the International Cancer of the Pancreas Screening Consortium, American Gastroenterological Association, and American Society of Gastrointestinal Endoscopy. However, there are limited analyses on the screening rates and barriers to adherence among HRIs. This study aims to describe real-world longitudinal screening adherence of a HRI surveillance cohort and identify potential barriers to adherence.
Patients followed by Stanford's Benign Pancreas Clinic were identified as HRIs if they met screening criteria per the latest abovementioned screening guidelines, and were included in our study if they underwent at least 1 screening exam. Data on HRIs were obtained retrospectively from our hospital's electronic health record system. Patient and screening characteristics were analyzed by adherence rates.
262 HRIs undergoing recommended screening were identified. The mean follow-up time per patient was 4.9 years and the mean successful annual screening rate within the entire cohort was 67%. HRIs in the lowest quartile of adherence were more likely to have more EUS rather than MRI surveillance exams compared to those who were completely adherent (p = 0.01). HRIs who were completely adherent were also an older cohort compared to those with non-complete adherence (p = 0.02) or in the lowest quartile of adherence (p = 0.01).
It is difficult to achieve high adherence rates for annual pancreatic cancer screening of HRIs as recommended by the latest guidelines. Age and screening modality may be factors that contribute to adherence difficulty.
背景/目的：筛查胰腺导管腺癌可改变高危个体（HRIs）的疾病进程，多个学会包括国际胰腺癌筛查联盟、美国胃肠病学会和美国胃肠内镜学会都推荐进行筛查。然而，关于HRIs的筛查率和依从性障碍的分析有限。本研究旨在描述HRIs监测队列的真实世界纵向筛查依从性，并确定潜在的依从性障碍。
斯坦福大学良性胰腺诊所随访的患者，如果符合上述最新筛查指南的筛查标准，则被确定为HRIs，并且如果他们至少接受了1次筛查检查，则纳入我们的研究。HRIs的数据是从我们医院的电子健康记录系统中回顾性获取的。通过依从率分析患者和筛查特征。
确定了262名接受推荐筛查的HRIs。每位患者的平均随访时间为4.9年，整个队列中的平均年度成功筛查率为67%。与完全依从的HRIs相比，依从性最低四分位数的HRIs更有可能接受更多的超声内镜检查而非磁共振成像监测检查（p = 0.01）。与依从性不完全的HRIs（p = 0.02）或依从性最低四分位数的HRIs（p = 0.01）相比，完全依从的HRIs也是年龄较大的队列。
按照最新指南的建议，对HRIs进行年度胰腺癌筛查很难实现高依从率。年龄和筛查方式可能是导致依从困难的因素。
