Abstract
Objective: We reported that the measurement of serum carbohydrate antigen (CA) 19-9 levels in routine health check-ups enabled us to detect resectable pancreatic cancers three years ago. Here, we report on our experience over the following six years.
Methods: A total of 99,807 persons receiving health check-ups in the period from April 2010 to July 2015 were enrolled in the present study. Approximately 80% of the subjects were repeat examinees. All subjects underwent CA19-9 measurement and abdominal ultrasonography. Those with elevated CA19-9 levels underwent further imaging examinations and were followed up every three months.
Results: The detection rate for pancreatic cancers in the first year was 0.025% but the average detection rate for the six years decreased to 0.010%. Out of 10 pancreatic cancers, nine were ductal cancers and one was a cystadenocarcinoma: two at stage I, one at stage II, four at stage IVa, and three at stage IVb. Therefore, the curative surgery rate was 70%. As for the sites of the pancreatic cancers, one was in the head, three were in the body, and six in the tail. Five subjects with tail cancer were diagnosed only on the basis of elevated CA19-9 levels, and four of them underwent curative surgery.
Conclusion: Using CA19-9 levels, four curable pancreatic tail cancers were detected, the first time for such a result to be reported in a mass screening study. Although measurement of CA19-9 levels may not be cost effective, it is useful in the early detection of pancreatic cancer in opportunistic screening.
