Alarmingly low detection rates of pancreatic cancer

A study revealed that pancreatic cancer was initially missed in CT or MRI scans in 7.7% of the affected patients, reducing chances of curative surgery.

Post-imaging pancreatic cancer: 3-18 months after wrong imaging

“There is often only a very short period for curative surgery in pancreatic cancer, meaning it is vital that patients are diagnosed with the disease as early as possible to give them the best chance of survival,” said Dr Nosheen Umar (University of Birmingham, United Kingdom)1. In this retrospective study, Dr Umar investigated records of 600 patients diagnosed with pancreatic cancer between 2016 and 2021 to determine if imaging signs of pancreatic cancer were missed.

Undergoing imaging that does not diagnose pancreatic cancer and 3 to 18 months later being diagnosed with pancreatic cancer was termed post-imaging pancreatic cancer (PIPC). CT and MRI images were independently reviewed by 2 radiologists to develop an algorithm that categorised the missed cases and identified the most likely explanation for PIPC cases. 

Almost half of PIPC cases located in the pancreatic head

Results revealed that 7.7% of cases were categorised as PIPC and almost half of them were located in the pancreatic head. Missed opportunities to potentially avoid PIPC were identified in 36.0% of PIPC cases. In only 40.4% of cases, no abnormality could be detected on initial imaging. 26.0% of PIPC patients had imaging signs of pancreatic cancer that were not recognised and investigated further. In 10.6% of PIPC patients, imaging signs associated with pancreatic cancer, such as dilated bile or pancreatic ducts, were detected but were inadequately followed up.

Pancreatic cancer is responsible for 95,000 deaths in the European Union every year and has the lowest survival rate of all cancers in Europe. Life expectancy at the time of diagnosis is just 4.6 months [2]. “We hope this study will raise awareness of the issue of PIPC and common reasons why pancreatic cancer can be initially missed,” Dr Umar concluded.

  1. Umar N, et al. How often is pancreatic cancer missed on CT or MRI imaging? A novel root cause analysis system to establish the most plausible explanation for post imaging pancreatic cancer. OP192, UEG Week 2022, Vienna, Austria, 8–11 October.
  2. Michl P, et al. United European Gastroenterol J. 2021;9:860–71.