Recommendation Statement
This statement summarizes the current U.S. Preventive Services
Task Force (USPSTF) recommendation on screening for pancreatic cancer, and
updates the 1996 recommendation in the Guide to Clinical Preventive
Services, Second Edition.1
Summary of Recommendation
- The U.S. Preventive Services Task Force (USPSTF) recommends against
routine screening for pancreatic cancer in asymptomatic adults using abdominal
palpation, ultrasonography, or serologic markers.
Rating: D Recommendation.
Rationale: The USPSTF found no evidence that screening for pancreatic
cancer is effective in reducing mortality. There is a potential for significant
harm due to the very low prevalence of pancreatic cancer, limited accuracy
of available screening tests, the invasive nature of diagnostic tests, and
the poor outcomes of treatment. As a result, the USPSTF concluded that the
harms of screening for pancreatic cancer exceed any potential benefits.
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Contents
Background
Clinical Considerations
References
Members of the Task Force
Contact the Task Force
Available Products
Copyright and Source Information
Background
The U.S. Preventive Services Task Force (USPSTF) last addressed screening
for pancreatic cancer in the 1996 Guide to Clinical Preventive Services and
recommended against screening for pancreatic cancer (D
recommendation).1
Since then, the USPSTF criteria to rate the strength of the evidence have
changed. Therefore, the recommendation statement that follows has been updated
and revised based on the current USPSTF methodology and rating of the strength
of the evidence.2
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Clinical Considerations
- Due to the poor prognosis of those diagnosed with pancreatic cancer,
there is an interest in primary prevention. The evidence for diet-based
prevention of pancreatic cancer is limited and conflicting. Some experts
recommend lifestyle
changes that may help to prevent pancreatic cancer, such as stopping the
use of tobacco products, moderating alcohol intake, and eating a balanced
diet
with sufficient fruit and vegetables.
- Persons with hereditary pancreatitis may have a higher lifetime risk
for developing pancreatic cancer.4 However,
the USPSTF did not review the effectiveness of screening these patients.
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References
1. U.S. Preventive Services Task Force; Guide to Clinical
Preventive Services. 2nd ed. Washington, DC: Office of Disease Prevention and
Health Promotion; 1996.
2. Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutsch
SM, Atkins D, for the Methods Word Group, third U.S. Preventive Services Task
Force. Current methods of the U.S. Preventive Services Task Force: a review
of the process. Am J Prev Med 2001;20(3S):21-35.
3. Screening for Pancreatic Cancer: update of the evidence for
the U.S Preventive Services Task Force. Agency for Healthcare Research and
Quality. 2004. Available at http://www.preventiveservices.ahrq.gov.
4. Lowenfels AB, Maisonneuve P, DiMagno EP, et al. Hereditary
pancreatitis and the risk of pancreatic cancer. International Hereditary Pancreatitis
Study Group. J Natl Cancer Inst 1997;89:442-6.
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Members of the Task Force
Members of the U.S. Preventive Services Task Force* are Alfred O. Berg, M.D., M.P.H., Chair, USPSTF (Professor
and Chair, Department of Family Medicine, University of Washington, Seattle,
WA); Janet D. Allan, Ph.D., R.N., C.S., Vice-chair, USPSTF (Dean, School of
Nursing, University of Maryland Baltimore, Baltimore, MD); Ned Calonge, M.D.,
M.P.H. (Acting Chief Medical Officer, Colorado Department of Public Health
and Environment, Denver, CO); Paul Frame, M.D. (Tri-County Family Medicine,
Cohocton, NY, and Clinical Professor of Family Medicine, University of Rochester,
Rochester, NY); Joxel Garcia, M.D., M.B.A. (Deputy Director, Pan American
Health Organization, Washington, DC); Russell Harris, M.D., M.P.H. (Associate
Professor of Medicine, Sheps Center for Health Services Research, University
of North Carolina School of Medicine, Chapel Hill, NC); Mark S. Johnson, M.D.,
M.P.H. (Professor of Family Medicine, University of Medicine and Dentistry
of New Jersey-New Jersey Medical School, Newark, NJ); Jonathan D. Klein, M.D.,
M.P.H. (Associate Professor, Department of Pediatrics, University of Rochester
School of Medicine, Rochester, NY); Carol Loveland-Cherry, Ph.D., R.N. (Executive
Associate Dean, School of Nursing, University of Michigan, Ann Arbor, MI);
Virginia A. Moyer, M.D., M.P.H. (Professor, Department of Pediatrics, University
of Texas at Houston, Houston, TX); C. Tracy Orleans, Ph.D. (Senior Scientist,
The Robert Wood Johnson Foundation, Princeton, NJ); Albert L. Siu, M.D., M.S.P.H.
(Professor of Medicine, Chief of Division of General Internal Medicine, Mount
Sinai School of Medicine, New York, NY); Steven M. Teutsch, M.D., M.P.H. (Senior
Director, Outcomes Research and Management, Merck & Company, Inc., West Point,
PA); Carolyn Westhoff, M.D., M.Sc. (Professor of Obstetrics and Gynecology and
Professor of Public Health, Columbia University, New York, NY); and Steven H.
Woolf, M.D., M.P.H. (Professor, Department of Family Practice and Department
of Preventive and Community Medicine and Director of Research Department of
Family Practice, Virginia Commonwealth University, Fairfax, VA).
* Member of the USPSTF at the time this recommendation was finalized. For a list of current Task Force members, go to http://www.ahrq.gov/clinic/uspstfab.htm.
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Contact the Task Force
Address correspondence to: Ned Calonge, M.D., M.P.H., Chair, U.S. Preventive Services Task Force; c/o Project Director, USPSTF; 540 Gaither Road; Rockville, MD 20850; E-mail: info@ahrq.gov.
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Available Products
This recommendation statement and the brief update, Screening for Pancreatic
Cancer: Brief Evidence Update for the U.S. Preventive Services Task Force,3 are
available on the USPSTF Web site at http://www.preventiveservices.ahrq.gov.
Recommendations made by the USPSTF are independent of the U.S. Government.
They should not be construed as an official position of AHRQ or the U.S.
Department of Health and Human Services.
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Copyright and Source Information
This document is in the public domain within the United States. For information on reprinting, contact Randie Siegel, Director, Division of Printing and Electronic Publishing, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850. Requests for linking or to incorporate content in electronic resources should be sent to: info@ahrq.gov.
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Current as of February 2004
Internet Citation:
U.S. Preventive Services Task Force. Screening for Pancreatic
Cancer: Recommendation Statement. February 2004. Agency for Healthcare Research
and Quality, Rockville, MD. http://www.ahrq.gov/clinic/3rduspstf/pancreatic/pancrers.htm