Prevention and early detection

Evidence summary and stakeholder input

The following is a summary of the findings from the evidence gathering activities and stakeholder consultations undertaken to inform development of the Roadmap. For more information on the development of the Roadmap see the About page.

Last updated: 31 March 2022

Risk factors

Evidence summary

Primary prevention provides a cost-effective long-term strategy to reduce the risk of cancer.  

While the cause of pancreatic cancer is unknown, smoking, diabetes mellitus, alcohol, obesity, and somatic and germline mutations have been shown to increase the risk of developing pancreatic cancer.¹⁻⁴ Other studies have shown some association between factors such as chronic pancreatitis, periodontal disease and severe teeth loss, and the development of pancreatic cancer.⁵𝄒⁶

Several modifiable risk factors for pancreatic cancer, such as smoking and obesity, have health benefits that extend beyond the prevention of pancreatic cancer and into other cancers and chronic diseases.

Stakeholder input

Over a third of all individual and organisational public consultation responses referenced risk factors and prevention as important issues that could make the biggest difference to pancreatic cancer outcomes.

Stakeholders supported continuing to promote and invest in implementation of existing preventive health strategies to reduce the prevalence of risk factors.

A lack of knowledge and awareness among the public and health professionals about causes of pancreatic cancer was highlighted, and education and campaigns to raise awareness, and framing information without blame, were supported.

A holistic approach to addressing risk factors including preventive health checks, management of associated chronic conditions, education and awareness campaigns, and lifestyle promotion and risk behaviour programs, including programs developed and delivered by Aboriginal and Torres Strait Islander people to suit local preferences and contexts are required.

Stakeholders also raised fear about the familial or genetic risk and identified strategies including genetic testing and counselling as well as the storage of biospecimens to study familial risk.

Early detection

Evidence summary

The early detection of pancreatic cancer can support the diagnosis of early-stage disease when treatments may result in better survival outcomes. 

While there is no current evidence to support population-level screening for pancreatic cancer, targeted surveillance programs present an opportunity to strengthen the early detection of pancreatic cancer among high-risk individuals. However, there is conflicting evidence on the psychosocial impact of surveillance for first-degree relatives at risk of pancreatic cancer.⁷𝄒⁸

The lack of validated biomarkers and imaging approaches suitable for long-term surveillance of at-risk cohorts presently limits the implementation of targeted surveillance.

For those with a strong family history of pancreatic cancer or related hereditary conditions, referral to a familial cancer service, geneticist or oncologist for genetic testing is recommended.⁹ Opportunities to increase clinicians’ knowledge about genetic testing is valuable to the management of an individual with pancreatic cancer, as well as broadening the reach of genetic testing as a cancer risk reduction and early detection tool.¹⁰

Clinician guidance on prevention and early detection, including the identification and screening of individuals at high risk of pancreatic cancer, can support the prevention and early detection of pancreatic cancer.

Stakeholder input

The lack of early detection and screening tests for pancreatic cancer together with the lack of validated biomarkers to support early detection and diagnosis was also raised by stakeholders.

While routine inclusion of cancer screening in the annual general health check for Aboriginal and Torres Strait Islander people and opportunistic cancer surveillance of individuals with risk factors such as diabetes, was raised, the large-scale separation of Aboriginal and Torres Strait Islander families in earlier generations means that many Indigenous people do not know the medical history of their biological family. 

Taken together with uncertainty, individual reluctance and mistrust of institutions, Aboriginal and Torres Strait Islander people may be deterred from taking up options for early detection. A range of contextual and logistical barriers for Aboriginal and Torres Strait Islander people, and other priority population groups, will need to be considered when providing access to future surveillance programs.

Key priority areas, strategies and activities 

Each key priority area has supporting strategies and associated activities for implementation in the short, medium or long term that have been identified to achieve the priority.