Pancreatic Cancer Surveillance Among High-Risk Populations: Knowledge and Intent
- 188 Downloads
Pancreatic cancer is the fourth most common cancer in both men and women in the United States. It has the lowest survival rate of all cancers, largely due to the presence of non-specific symptoms, leading to diagnosis at advanced stages. While the majority of cases of pancreatic cancer are sporadic, up to 10% may be associated with an inherited predisposition. Currently, there is no standard screening protocol for pancreatic cancer, although this will change in the future as technology improves. Additionally, there is little information regarding the perceptions and intent to screen for pancreatic cancer among those with an increased risk due to a hereditary cancer predisposition syndrome, which was the objective of this study. Focus groups and individual telephone interviews were conducted, with questions focused on knowledge about pancreatic cancer and screening, perceived motivators, and perceived barriers related to each of the screening techniques currently available. Participants were recruited from the High Risk Breast Cancer and Pancreatic Cancer Registries at Huntsman Cancer Institute. The findings of this study indicated that individuals from these high-risk groups have low knowledge levels of pancreatic cancer screening, despite their desire for this information. Motivation to undergo a particular screening technique is related to whether the test is recommended by a physician, cost, degree of invasiveness, and comfort level. This information is useful to genetics professionals who counsel at-risk individuals, physicians who formulate patient care plans, and translational researchers who are developing pancreatic screening methods.
KeywordsPancreatic cancer Pancreatic cancer screening Screening uptake Motivators Barriers The Health Belief Model
This manuscript is based on a research project conducted by Zoe Lewis to fulfill the requirements of the University of Utah Master’s Degree in Genetic Counseling. Financial support was provided by a grant from the Huntsman Cancer Institute Pancreatic Cancer Research Program; the Huntsman Cancer Foundation, which funds the genetic counseling core at Huntsman Cancer Institute; and a grant from the University of Utah Graduate Program in Genetic Counseling. The authors would like to thank the following individuals for their contributions to this study: Tom Conner, Nicole Oman, and Elynn Beck for their assistance in recruiting study participants; Emogene Grundvig for assisting with the focus groups; and Heidi Slack for assisting with transcription.
Conflict of Interest
The authors indicate no potential conflicts of interest.
- Borg, A., Sandberg, T., Nilsson, K., Johannsson, O., Klinker, M., Masback, A., et al. (2000). High frequency of multiple melanomas and breast and pancreas carcinomas in cdkn2a mutation-positive melanoma families. Journal of the National Cancer Institute, 92(15), 1260–1266. doi: 10.1093/jnci/92.15.1260.PubMedCrossRefGoogle Scholar
- Canto, M. I., Goggins, M., Hruban, R. H., Petersen, G. M., Giardiello, F. M., Yeo, C., et al. (2006). Screening for early pancreatic neoplasia in high-risk individuals: A prospective controlled study. Clinical Gastroenterology and Hepatology, 4(6), 766–781 quiz 665doi: 10.1016/j.cgh.2006.02.005.PubMedCrossRefGoogle Scholar
- Cwik, G., Wallner, G., Skoczylas, T., Ciechanski, A., & Zinkiewicz, K. (2006). Cancer antigens 19-9 and 125 in the differential diagnosis of pancreatic mass lesions. Archives of surgery (Chicago, Ill.), 141(10), 968–973 discussion 974.Google Scholar
- Eberle, M. A., Pfutzer, R., Pogue-Geile, K. L., Bronner, M. P., Crispin, D., Kimmey, M. B., et al. (2002). A new susceptibility locus for autosomal dominant pancreatic cancer maps to chromosome 4q32-34. American Journal of Human Genetics, 70(4), 1044–1048. doi: 10.1086/339692.PubMedCrossRefGoogle Scholar
- Fischera, S. D., & Frank, D. I. (1994). The health belief model as a predictor of mammography screening. Health Values: The Journal of Health Behavior. Education and Promotion, 18(4), 3.Google Scholar
- Frebourg, T., Bercoff, E., Manchon, N., Senant, J., Basuyau, J. P., Breton, P., et al. (1988). The evaluation of ca 19-9 antigen level in the early detection of pancreatic cancer. A prospective study of 866 patients. Cancer, 62(11), 2287–2290 doi: 10.1002/1097-0142(19881201)62:11<2287::AID-CNCR2820621103>3.0.CO;2-H.PubMedCrossRefGoogle Scholar
- Goldstein, A. M., Fraser, M. C., Struewing, J. P., Hussussian, C. J., Ranade, K., Zametkin, D. P., et al. (1995). Increased risk of pancreatic cancer in melanoma-prone kindreds with p16ink4 mutations. The New England Journal of Medicine, 333(15), 970–974. doi: 10.1056/NEJM199510123331504.PubMedCrossRefGoogle Scholar
- Klein, D. A. (2002). Using the health belief model as a framework for predicting adherence to colorectal cancer screening: A study of women undergoing routine mammography. ProQuest Information and Learning.Google Scholar
- Locker, G. Y., Hamilton, S., Harris, J., Jessup, J. M., Kemeny, N., Macdonald, J. S., et al. (2006). Asco 2006 update of recommendations for the use of tumor markers in gastrointestinal cancer. Journal of Clinical Oncology, 24(33), 5313–5327. doi: 10.1200/JCO.2006.08.2644.PubMedCrossRefGoogle Scholar
- Ries, L., Harkins, D., Krapcho, M., Mariotto, A., Miller, B., Feuer, E., et al.(2006). Seer cancer statistics review, 1975–2003. Retrieved May, 2007, from http://seer.cancer.gov/csr/1975_2003/.
- Rosenberg, L., Wise, L. A., Palmer, J. R., Horton, N. J., & Adams-Campbell, L. L. (2005). A multilevel study of socioeconomic predictors of regular mammography use among african-american women. Cancer Epidemiology, Biomarkers & Prevention, 14(11 Pt 1), 2628–2633. doi: 10.1158/1055-9965.EPI-05-0441.CrossRefGoogle Scholar
- Soriano, A., Castells, A., Ayuso, C., Ayuso, J. R., de Caralt, M. T., Gines, M. A., et al. (2004). Preoperative staging and tumor resectability assessment of pancreatic cancer: Prospective study comparing endoscopic ultrasonography, helical computed tomography, magnetic resonance imaging, and angiography. The American Journal of Gastroenterology, 99(3), 492–501. doi: 10.1111/j.1572-0241.2004.04087.x.PubMedCrossRefGoogle Scholar
- Vasen, H. F., Gruis, N. A., Frants, R. R., van Der Velden, P. A., Hille, E. T., & Bergman, W. (2000). Risk of developing pancreatic cancer in families with familial atypical multiple mole melanoma associated with a specific 19 deletion of p16 (p16-leiden). International Journal of Cancer, 87(6), 809–811 doi: 10.1002/1097-0215(20000915)87:6<809::AID-IJC8>3.0.CO;2-U.CrossRefGoogle Scholar
- Zervos, E. E., Tanner, S. M., Osborne, D. A., Bloomston, M., Rosemurgy, A. S., Ellison, E. C., et al. (2006). Differential gene expression in patients genetically predisposed to pancreatic cancer. The Journal of Surgical Research, 135(2), 317–322. doi: 10.1016/j.jss.2006.03.022.PubMedCrossRefGoogle Scholar