Putting Prevention into Practice
An Evidence-Based Approach
Screening for Pancreatic Cancer
Am Fam Physician. 2019 Dec 15;100(12):771-772.
Author disclosure: No relevant financial affiliations.
A 71-year-old woman comes to your office for a regularly scheduled visit. She has type 2 diabetes mellitus and a 50-pack-year smoking history, and had non-ulcer dyspepsia two years ago. Her body mass index is 32 kg per m2, and her blood pressure is normal. She says that she feels well and has no abdominal pain, weight loss, or any other symptoms. She has no family history of pancreatic, colon, breast, or ovarian cancer. She tells you that her best friend has been recently diagnosed with pancreatic cancer and is about to undergo surgery. She asks whether she can be screened for pancreatic cancer.
Case Study Questions
1. Based on the U.S. Preventive Services Task Force (USPSTF) recommendation statement, how should you counsel this patient?
A. She should not be screened for pancreatic cancer. She is asymptomatic, and based on her medical and family history, she is not at high risk of pancreatic cancer.
B. She should be screened for pancreatic cancer because she is older and has type 2 diabetes.
C. She should be screened for pancreatic cancer because of her history of cigarette smoking.
D. She should be screened for pancreatic cancer with computed tomography, endoscopic ultrasonography, or magnetic resonance imaging.
E. She should be screened for pancreatic cancer with a multiple biomarker panel.
2. Which of the following people are at high risk of pancreatic cancer and therefore fall outside the scope of the USPSTF recommendation on screening for pancreatic cancer?
A. People who have preexisting diabetes.
B. People who have Peutz-Jeghers syndrome.
C. People who have a history of cigarette smoking.
D. People who have a history of familial pancreatic cancer.
3. Which one of the following statements represents the USPSTF's findings regarding the potential benefits and harms of screening for pancreatic cancer?
A. The USPSTF found adequate evidence that screening for pancreatic cancer improves disease-specific morbidity but not all-cause mortality.
B. The USPSTF found adequate
1. Owens DK, Davidson KW, Krist AH, et al. Screening for pancreatic cancer: US Preventive Services Task Force reaffirmation recommendation statement. JAMA. 2019;322(5):438–444.
2. Henrikson NB, Aiello Bowles EJ, Blasi PR, et al. Screening for pancreatic cancer: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2019;322(5):445–454.
This PPIP quiz is based on the recommendations of the USPSTF. More information is available in the USPSTF Recommendation Statement and supporting documents on the USPSTF website (https://www.uspreventiveservicestaskforce.org). The practice recommendations in this activity are available at https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/pancreatic-cancer-screening1.
This series is coordinated by Kenny Lin, MD, MPH, deputy editor.
A collection of Putting Prevention into Practice published in AFP is available at https://www.aafp.org/afp/ppip.
Copyright © 2019 by the American Academy of Family Physicians.
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