Pancreatic cancer still lacks effective form of screening

very few cases where the cancer can be found early enough to make a difference.

Every study done so far on screening for pancreatic cancer has shown no reduction in the rate of death from pancreatic cancer. Even when found early by CT, ultrasound or blood testing, it usually is already too late for most.

While I rejoice for Justice Ruth Bader Ginsburg, to whom I think you probably refer, she was one of the lucky few.

A reasonable followup might be: Even if screening only saves a few people, isn’t it worth doing?

Unfortunately, there are downsides to screening. There are dollar costs of the tests. CT scans in particular have radiation, which if repeated, over time can increase the risk of developing other kinds of cancers.

More importantly, scans can show findings that appear to be cancer or another abnormality, but on surgical biopsy turn out to be nothing important. This causes people to be operated on unnecessarily.

So far, the harms of screening, even though they seem small, outweigh the much smaller chance of finding a curable cancer.

It is possible that breakthroughs in treatment will lead to a new era for pancreatic cancer, where formerly incurable disease can be successfully treated. If (hopefully when) that happens, screening then may be re-evaluated.

I should note that this discussion applies to people with no known risk factors for pancreatic cancer. Perhaps 10 to 15 percent of pancreatic cancer has a familial component.

People with a strong family history of pancreatic cancer or those with a genetic condition that predisposes to pancreatic cancer (such as BRCA2 or BRCA1) should consider enrolling in a study or finding a center with expertise in screening high-risk people for pancreatic cancer, where testing is more likely to have benefit.