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Year : 2016  |  Volume : 5  |  Issue : 1  |  Page : 8-16

The role of endoscopic ultrasound in pancreatic cancer screening

1 Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA
2 Department of Gastroenterology, Ochsner Clinic Foundation, Ochsner Cancer Institute, New Orleans, Louisiana, USA
3 Department of Gastroenterology, Royal Prince Alfred Hospital, Sydney, Australia
4 Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, , Aizuwakamatsu, Fukushima, Japan
5 Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu, Fukushima, Japan
6 Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan

Correspondence Address:
Manoop S Bhutani
Department of Gastroenterology, Hepatology and Nutrition, Unit 1466, MD Anderson Cancer Center, University of Texas, 1515 Holcombe Boulevard, Houston 77030-4009, Texas
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2303-9027.175876

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Pancreatic cancer (PC) is a highly lethal cancer. Despite a significant advancement in cancer treatment, the mortality rate of PC is nearly identical to the incidence rates. Early detection of tumor or its precursor lesions with dysplasia may be the most effective approach to improve survival. Screening strategies should include identification of the population at high risk of developing PC, and an intense application of screening tools with adequate sensitivity to detect PC at an early curable stage. Endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) seem to be the most promising modalities for PC screening based on the data so far. EUS had an additional advantage over MRI by being able to obtain tissue sample during the same examination. Several questions remain unanswered at this time regarding the age to begin screening, frequency of screening, management of asymptomatic pancreatic lesions detected on screening, timing of resection, and extent of surgery and impact of screening on survival. Novel techniques such as needle-based confocal laser endomicroscopy (nCLE), along with biomarkers, may be helpful to identify pancreatic lesions with more aggressive malignant potential. Further studies will hopefully lead to the development of strategies combining EUS with other technological/biological advancements that will be cost-effective and have an impact on survival.

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