Factors affecting compliance with pancreas surveillance in patients with familial/genetic risk

To achieve early pancreatic cancer detection, patients with familial/genetic predisposition need to maintain regular surveillance with EUS and/or MRI for many years. Factors influencing compliance with pancreatic surveillance compliance are not well understood.

We conducted a one-time cross-sectional survey of patients enrolled in the ongoing Cancer of the Pancreas Screening 5 (CAPS5) study at Johns Hopkins Hospital. Patients answered a 21-item questionnaire that assessed demographic, financial, psychological, and clinical factors that could potentially affect their compliance with pancreatic surveillance. Descriptive, univariate, and multivariate analysis were performed to determine factors independently associated with compliance with surveillance recommendations.

The survey was sent to 996 HRI in April 2025; 774 responded (mean respondent age 65.25 ± 10.22 years, 62.3% female); 88.7% reported being compliant. In multivariate analysis, compliance was significantly lower among participants reporting personal, work-related, or logistical challenges with making/keeping appointments (p < 0.01), having significant insurance copayments (p = 0.017), or reporting fear of a pancreatic cancer diagnosis (p = 0.013). Reporting that pancreatic surveillance tests provided reassurance (p = 0.001), or provoked anxiety (p = 0.021) were also associated with higher compliance, as was having a strong support system (p = 0.03). Patients who preferred EUS over MRI were also significantly more likely to report being compliant (p = 0.011). Finally, patients who had undergone cancer susceptibility gene testing were more compliant than those who had not (p = 0.016), though there was no significant difference in compliance rates among gene-test-positive versus gene-test-negative patients (p = 0.82).

Recognizing and addressing factors associated with reduced compliance may help improve compliance with pancreatic surveillance.