Surveillance Improves Outcomes for High-Risk Patients


There’s good news for those at high risk of pancreatic cancer.

The majority of high-risk patients diagnosed with the disease while enrolled in a multidisciplinary surveillance program have stage I disease. Not only are these patients candidates for surgery—the only potential cure for the disease—but most are long-term survivors. The study found that more than 70 percent of patients were still alive five years later.

The research, dubbed The Cancer of the Pancreas Screening-5 (CAPS5) Study, which was published in June 2022 in the Journal of Clinical Oncology, found high-risk patients diagnosed with pancreatic cancer while enrolled in the CAPS surveillance program had a median survival of 9.8 years.

“When we started this [CAPS5], we didn’t know if surveillance was going to make a difference in terms of being of benefit to a patient,” says senior author Michael Goggins, M.B.B.Ch., M.D., the Sol Goldman Professor of Pancreatic Cancer Research and director of the Pancreatic Cancer Early Detection Laboratory at Johns Hopkins (Baltimore). “But what we see is that a very clear majority of patients who kept up with surveillance and then were diagnosed with pancreatic cancer had early stage disease. So to have patients be diagnosed at stage I when they can have surgery is a clear benefit since right now surgery is the only potential chance for long-term survival and for some maybe a cure. What we showed is that surveillance works.”

Although the pancreatic cancer survival rate now hovers around 11 percent, most patients are unfortunately still diagnosed at a later stage, which contributes to this poor survival rate. But largely due to improvements in imaging, a better understanding of the biology of the disease—leading to better, more tailored treatments for some patients—and enrollment of high-risk patients in surveillance programs, things are “incrementally improving,” adds Goggins. “We clearly need biomarkers for this disease so we can detect it earlier. And there is a lot of research going on in that area. Pancreatic cancer is very formidable, and it is also relatively rare. So having screening for everyone without symptoms or risk isn’t feasible or of benefit. But there is some significant work being doneformultisite cancer tests, including one developed here at Hopkins. We need to see how that research plays out.

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