Abstract
In Japan, 29,000 people died of pancreatic cancer in 2011. The number has been increasing recently. Whereas, the 5-year survival rate of pancreatic cancer has remained at less than 10% for the past 50 years.
To improve the long-term survival, early detection is necessary. But, the pancreas is a small organ situated in a retroperitoneal cavity. Therefore, detailed examination is necessary to detect pancreatic cancer in an early stage without invasion to the surrounding tissue. The current screening with detailed examination for healthy people to detect early pancreatic cancer is not efficient. We propose a systematic approach composed of 3 steps for the detection of early stage pancreatic cancer. The 1st step is to detect high risk people, such as those with pancreatic cyst and/or main pancreatic duct dilatation. The 2nd step is to follow up the high-risk people strictly and identify any faint sign suggestive of the development of pancreatic cancer. The 3rd step is to perform an adequate examination and reach a definitive diagnosis of pancreatic cancer in an early stage. At the Osaka Medical Center for cancer and CVD, we started the above system in 1998. By March 2011 (mean follow-up period: 71.89 months), pancreatic cancer had developed in 27 of 1,023 high-risk people. Of these pancreatic cancer cases, 67% were diagnosed at the early stage of Stage 0, 1A or 1B. Surgical resection was performed in 74%. And the 5-year survival rate of the 27 cases after diagnosis was 54.6%.
