12/16/2025
What’s a Pancreatic Cancer Doctor to do? More Importantly: What are Their Patients to do?
Screening for Pancreatic cancer, even in the highest-risk individuals found not cost effective.
According to a large study conducted by investigators at Harvard University, (Peters, MLB J Clin Oncol, February 2024) the available techniques used to screen for early stage (curable) pancreatic cancer including genomic tests, MRI and endoscopy are not cost effective.
Using a microsimulation model applied to individuals at the highest risk for this lethal disease, the cost to save one life using these genetically identified individuals went as high at $404,000/year of life saved. Contemporary re-imbursement allowances from insurers, Medicare and others use a cut-off of $100,000/year of life saved, less than one fourth of this figure.
The most widely recognized DNA mutations known to predispose individuals to pancreatic cancer include BRCA1, BRCA2, ATM, Lynch syndrome and others. However, not one of these met the standard. Two DNA mutations that did manage to cross the threshold are the relatively rare CDKN2A and STK11.
The take home message is that contemporary gene tests have no meaningful impact on cancer detection in most patients and when they are applied, they fail to guide even the highest risk individuals to better outcomes at a cost that our society can or is willing to pay.
NCI can help. Call for info if you are interested in screening or if you know someone diagnosed with Pancreatic Cancer who wants options.
