1.3 Early detection
There is no recommended population screening program for pancreatic cancer in Australia.
The cancer antigen 19-9 (CA 19-9) tumour marker is not recommended as a population screening tool for pancreatic cancer due to the low sensitivity and specificity of the test, but rather it should be used as a marker of response to treatment (NCI 2019a).
For people with a strong family history of pancreatic cancer (those who have two or more close relatives affected by pancreatic cancer) and those with a family history of pancreatic cancer–related hereditary conditions (BRCA 2, Lynch syndrome, FAMMM syndrome and Peutz-Jeghers syndrome), it is recommended that they are referred to a familial cancer service, geneticist or oncologist for genetic testing (Goggins et al. 2019).
Potential imaging for monitoring pancreatic cancer in high-risk populations includes a range of imaging modalities; however, endoscopic ultrasound is generally accepted as the most sensitive imaging test for small pancreatic head tumours. Blood samples (CA 19-9, carcinoembryonic antigen [CEA] and liver biochemistry) are also collected.