Friday, November 25, 2022

Alarming gaps in pancreatic cancer diagnosis revealed in a study

Pancreatic cancer tumors are being missed on CT and MRI scans,

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According to a new study presented at UEG Week 2022, missing pancreatic cancer tumors on CT and MRI scans reduces the window for curative surgery that could save a patient’s life. Over a third (36%) of PIPC cases were possibly preventable, showing a low detection rate for cancer with alarming patient outcomes.

The study examined post-imaging pancreatic cancer (PIPC) cases, which occur when a patient has imaging that misses the diagnosis of pancreatic cancer but subsequently receives the diagnosis. Six hundred patients diagnosed with pancreatic cancer between 2016 and 2021 were the subject of a UK study. Of those, 46 (7.7%) individuals later received a pancreatic cancer diagnosis between three and 18 months after their first scan failed to detect their cancer.

Radiologists independently reviewed CT and MRI images to develop an algorithm to categorize the missed cases and identify the most likely explanation for why they were missed.

Dr. Nosheen Umar, the lead author of the study from the University of Birmingham, UK, commented, “There is often only a brief period for curative surgery in pancreatic cancer, meaning it is vital that patients are diagnosed with the disease as early as possible to give them the best chance of survival. The study found that evidence of pancreatic cancer was initially missed in over a third of patients with post-imaging pancreatic cancers, which is a huge window of lost opportunity.”

When a specialized hepatobiliary radiologist reviewed scans, cancer signals were missed in nearly half (48%) of PIPC patients. Imaging indicators of pancreatic cancer, such as dilated bile or pancreatic ducts, went unnoticed and uninvestigated in 28% of PIPC patients.

Dr. Umar said“We hope this study will raise awareness of the issue of post-imaging pancreatic cancer and common reasons why pancreatic cancer can be initially missed. This will help to standardize future studies of this issue and guide quality improvement efforts, so we can increase the likelihood of an early diagnosis of pancreatic cancer, increase the chances of patient survival, and, ultimately, save lives.”

Journal Reference:

  1. Umar N et al. How often is pancreatic cancer missed on CT or MRI imaging? A novel root cause analysis system establishes the most plausible explanation for post-imaging pancreatic cancer. Presented at UEG Week 2022; 11 October 2022; Vienna, Austria.
  2. United European Gastroenterology (UEG). UEG Position Paper, Pancreatic Cancer: a medical emergency. 2021. Paper
  3. Löhr M. Pancreatic cancer should be treated as a medical emergency. BMJ. 2014 Sep 4;349:g5261. DOI: 10.1136/bmj.g5261. 4. United European Gastroenterology (UEG). Pancreatic Cancer Across Europe: Taking a united stand. 2018. Paper
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