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Abstract(s)
O cancro do pâncreas é o 6º cancro mais mortal em Portugal, representando 5,5% de todas
as mortes por cancro no país. Mundialmente, estima-se que entre 2018 e 2040 a sua
incidência e mortalidade aumentem 77,7% e 79,9%, respetivamente.
Existe um intervalo de vários anos até ao aparecimento da neoplasia maligna e,
consequentemente, da sintomatologia. Este período assintomático representa uma
oportunidade para o rastreio e deteção precoce do tumor num estádio inicial ou das suas
lesões percursoras, permitindo uma abordagem terapêutica potencialmente curativa.
Vários fatores de risco identificados, genéticos e não genéticos, aumentam a predisposição
para o desenvolvimento de cancro do pâncreas. Dada a reduzida incidência da doença, a
população geral parece não beneficiar do rastreio da neoplasia num estádio inicial ou das
suas lesões percursoras, estando apenas recomendado em populações com risco de
desenvolvimento do cancro do pâncreas ao longo da vida superior a 5%. Assim, vários
autores recomendam o rastreio em indivíduos de alto risco, nomeadamente, cancro do
pâncreas familiar e em algumas síndromes genéticas. Estudos apontam que, nessa
população, o tempo de sobrevida aumenta significativamente e que as taxas de resseção
curativas são elevadas.
Atualmente, o rastreio baseia-se em métodos de imagem como a ecoendoscopia e a
ressonância magnética. Alguns estudos sugerem que estes são complementares e que
poderão ser usados simultaneamente. Ainda assim, recentemente, têm surgido métodos
mais seguros, menos invasivos e com resultados promissores.
Realizou-se uma revisão da literatura sobre os principais fatores de risco para o
desenvolvimento de cancro do pâncreas, as lesões pré-malignas da neoplasia, as
recomendações sobre a população-alvo a rastrear, os métodos de rastreio disponíveis e em
desenvolvimento, bem como o custo-efetividade do rastreio.
Pancreatic cancer is the 6th deadliest cancer in Portugal, representing 5.5% of all cancer deaths in the country. Worldwide, its incidence and mortality are estimated to increase by 77.7% and 79.9% respectively between 2018 and 2040. There is a period of several years until the appearance of malignant neoplasia and, consequently, symptomatology. This asymptomatic period represents an opportunity for early screening and detection of the tumor at an early stage or of its precursor lesions, allowing a potentially curative therapeutic approach. There are several identified risk factors, genetic and non-genetic, which increase the predisposition to pancreatic cancer development. Given the low incidence of the disease, the general population does not appear to benefit from screening for neoplasia at an early stage or its precursor lesions and is only recommended in populations at risk of developing pancreatic cancer over a lifetime of more than 5%. Therefore, several authors recommend screening in high-risk individuals, namely family pancreatic cancer and some genetic syndromes. Studies indicate that in this population survival time increases significantly and that rates of curative resection are high. Currently, screening is based on imaging methods such as echoendoscopy and magnetic resonance imaging. Some studies suggest that these are complementary and can be used simultaneously. Even so, recently, safer, less invasive methods with promising results have emerged. This work has consisted of a review of the literature on the main risk factors for developing pancreatic cancer, recommendations on the target population to be screened, available and developing screening methods and the cost-effectiveness of screening.
Pancreatic cancer is the 6th deadliest cancer in Portugal, representing 5.5% of all cancer deaths in the country. Worldwide, its incidence and mortality are estimated to increase by 77.7% and 79.9% respectively between 2018 and 2040. There is a period of several years until the appearance of malignant neoplasia and, consequently, symptomatology. This asymptomatic period represents an opportunity for early screening and detection of the tumor at an early stage or of its precursor lesions, allowing a potentially curative therapeutic approach. There are several identified risk factors, genetic and non-genetic, which increase the predisposition to pancreatic cancer development. Given the low incidence of the disease, the general population does not appear to benefit from screening for neoplasia at an early stage or its precursor lesions and is only recommended in populations at risk of developing pancreatic cancer over a lifetime of more than 5%. Therefore, several authors recommend screening in high-risk individuals, namely family pancreatic cancer and some genetic syndromes. Studies indicate that in this population survival time increases significantly and that rates of curative resection are high. Currently, screening is based on imaging methods such as echoendoscopy and magnetic resonance imaging. Some studies suggest that these are complementary and can be used simultaneously. Even so, recently, safer, less invasive methods with promising results have emerged. This work has consisted of a review of the literature on the main risk factors for developing pancreatic cancer, recommendations on the target population to be screened, available and developing screening methods and the cost-effectiveness of screening.
Description
Keywords
Cancro do Pâncreas Deteção Precoce Rastreio