2014 Volume 41 Issue 2 Pages 259-267
Recent reports have described that early detection of pancreatic cancer can be facilitated by using endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) for histological or cytological examinations, or by close follow-up observation of high-risk groups, such as branch duct intraductal papillary mucinous neoplasm (branch duct IPMN) cases. We studied the results of medical checkups for pancreatic cancer by abdominal ultrasonography on 14,151 subjects (9,355 males and 4,796 females; mean age 52) receiving general medical checkups in fiscal 2011. The results showed findings in 2.0% of subjects, and the detection rates of pancreatic cysts and dilated pancreatic ducts, which are indirect findings of pancreatic cancer, were 1.0% and 0.6%, respectively. The detection rate of pancreatic cysts was above that reported at other institutions (0.7%). Among subjects advised to receive a thorough pancreatic cancer examination, 78% did so, and the pancreatic cancer detection rate was 0.007%, which both compared well to other medical checkup facilities. Branch duct IPMN, involving a high pancreatic cancer risk, had a 0.12% detection rate, occurring more often with complications of pancreatic cysts with dilated pancreatic ducts. Such cases would require thorough examinations and follow-up observation. The detection rate of pancreatic tumors in the thorough examinations was 0.15%. The detection rate with EUS was 100%, but CT/MRI was lower (18%). However, most cases underwent only CT/MRI, and no more than 10% underwent EUS. To enhance screening efficiency, it is important for a screening facility to increase pancreatic imaging capacity and elevate detection rates for groups with higher risks of pancreatic cancers including pancreatic cysts, dilated pancreatic ducts, and branch duct IPMN.