Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Model-based screening for pancreatic cancer in Sweden

Draus, Tomasz LU orcid ; Ansari, Daniel LU and Andersson, Roland LU (2023) In Scandinavian Journal of Gastroenterology 58(5). p.534-541
Abstract

Background: Detecting pancreatic cancer at an earlier stage may contribute to an increased survival. Patients with stage I pancreatic cancer have a 5-year survival rate of 36%, while stage IV patients have a 5-year survival rate of 1% in Sweden. Research into novel blood-based biomarkers for pancreatic cancer is highly intensive and innovative, but has yet to result in any routine screening test. The aim of this study was to evaluate the specificity and sensitivity of a hypothetical blood test for pancreatic cancer used for screening purposes and the economic aspects of testing. Method: A model of a screening test was created, with varying specificity and sensitivity both set at 80%, 85%, 90%, 95% or 99% and applied to selected risk... (More)

Background: Detecting pancreatic cancer at an earlier stage may contribute to an increased survival. Patients with stage I pancreatic cancer have a 5-year survival rate of 36%, while stage IV patients have a 5-year survival rate of 1% in Sweden. Research into novel blood-based biomarkers for pancreatic cancer is highly intensive and innovative, but has yet to result in any routine screening test. The aim of this study was to evaluate the specificity and sensitivity of a hypothetical blood test for pancreatic cancer used for screening purposes and the economic aspects of testing. Method: A model of a screening test was created, with varying specificity and sensitivity both set at 80%, 85%, 90%, 95% or 99% and applied to selected risk groups. Excessive costs of false positive screening outcomes, QALYs, ICERs and total costs were calculated. Results: Individuals with family history and genetic mutations associated with pancreatic cancer, new-onset diabetes ≥50 years of age and early symptoms had the highest positive predictive values and ICERs beneath the willingness-to-pay-level of EUR 100,000/QALY. Screening of the general population and smokers resulted in a high rate of false positive cases and extensive extra costs. Conclusions: General screening for pancreatic cancer is not cost-effective, while screening of certain high-risk groups may be economically justified given the availability of a high-performing blood-based test.

(Less)
Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
biomarkers, economic burden, Pancreatic cancer, screening, Sweden
in
Scandinavian Journal of Gastroenterology
volume
58
issue
5
pages
534 - 541
publisher
Taylor & Francis
external identifiers
  • pmid:36440687
  • scopus:85142909006
ISSN
0036-5521
DOI
10.1080/00365521.2022.2142481
language
English
LU publication?
yes
id
276ce1df-cf75-41db-91af-9cbfea98a705
date added to LUP
2023-01-30 15:43:17
date last changed
2024-06-23 12:37:50
@article{276ce1df-cf75-41db-91af-9cbfea98a705,
  abstract     = {{<p>Background: Detecting pancreatic cancer at an earlier stage may contribute to an increased survival. Patients with stage I pancreatic cancer have a 5-year survival rate of 36%, while stage IV patients have a 5-year survival rate of 1% in Sweden. Research into novel blood-based biomarkers for pancreatic cancer is highly intensive and innovative, but has yet to result in any routine screening test. The aim of this study was to evaluate the specificity and sensitivity of a hypothetical blood test for pancreatic cancer used for screening purposes and the economic aspects of testing. Method: A model of a screening test was created, with varying specificity and sensitivity both set at 80%, 85%, 90%, 95% or 99% and applied to selected risk groups. Excessive costs of false positive screening outcomes, QALYs, ICERs and total costs were calculated. Results: Individuals with family history and genetic mutations associated with pancreatic cancer, new-onset diabetes ≥50 years of age and early symptoms had the highest positive predictive values and ICERs beneath the willingness-to-pay-level of EUR 100,000/QALY. Screening of the general population and smokers resulted in a high rate of false positive cases and extensive extra costs. Conclusions: General screening for pancreatic cancer is not cost-effective, while screening of certain high-risk groups may be economically justified given the availability of a high-performing blood-based test.</p>}},
  author       = {{Draus, Tomasz and Ansari, Daniel and Andersson, Roland}},
  issn         = {{0036-5521}},
  keywords     = {{biomarkers; economic burden; Pancreatic cancer; screening; Sweden}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{534--541}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Gastroenterology}},
  title        = {{Model-based screening for pancreatic cancer in Sweden}},
  url          = {{http://dx.doi.org/10.1080/00365521.2022.2142481}},
  doi          = {{10.1080/00365521.2022.2142481}},
  volume       = {{58}},
  year         = {{2023}},
}