Model-based screening for pancreatic cancer in Sweden

Area of Science:

• Oncology
• Biomarker Discovery
• Health Economics

Background:

• Early detection of pancreatic cancer is crucial for improving patient survival rates.
• Current research focuses on novel blood-based biomarkers, but no routine screening test exists.
• This study evaluates the economic viability of a hypothetical pancreatic cancer blood screening test.

Purpose of the Study:

• To assess the cost-effectiveness of a hypothetical blood-based pancreatic cancer screening test.
• To determine the impact of varying test sensitivity and specificity on economic outcomes.
• To identify optimal screening strategies for pancreatic cancer.

Main Methods:

• A simulation model was developed to evaluate a hypothetical pancreatic cancer screening test.
• Test performance metrics (specificity and sensitivity) were varied from 80% to 99%.
• Economic outcomes, including costs, Quality-Adjusted Life Years (QALYs), and Incremental Cost-Effectiveness Ratios (ICERs), were calculated for different risk groups.

Main Results:

• High-risk groups (family history, genetic mutations, new-onset diabetes, early symptoms) demonstrated high positive predictive values and acceptable ICERs.
• Screening the general population or smokers led to numerous false positives and significantly increased costs.
• Economic justification for screening was found only in specific, carefully selected high-risk populations.

Conclusions:

• General population screening for pancreatic cancer is not economically feasible.
• Targeted screening of individuals with specific risk factors may be cost-effective if a highly accurate blood test becomes available.
• Future efforts should focus on developing high-performing biomarkers for targeted pancreatic cancer screening.