Diagnosing pancreatic cancer--an analysis of several strategies.
The usefulness of a clinical examination was compared with several other procedures (ultrasonography, pancreatic function tests, endoscopic retrograde cholangiopancreatography and angiography) for diagnosing pancreatic cancer. We used a simplified form of decision analysis to show the effects of different strategies on direct diagnostic costs, missed diagnoses and false-positive diagnoses. Our analysis indicates that existing laboratory tests are either too non-specific or too invasive to be used successfully as screening tests for pancreatic cancer. To decrease the number of unnecessary laparotomies due to false-positive test findings, patients should have a high probability of pancreatic cancer, based on clinical criteria, before further testing is carried out. In fact, existing clinical criteria are both sensitive and specific for pancreatic cancer.
D004724:Endoscopy; D006801:Humans; D007813:Laparotomy; D008433:Mathematics; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011859:Radiography; D014463:Ultrasonography