title: Feasibility of a pancreatic cancer surveillance program from a psychological point of view.
abstract: OBJECTIVE
  : The success of any surveillance program depends not solely on its technological aspects but also on the commitment of participants to adhere to follow-up investigations, which is influenced by the psychological impact of surveillance. This study investigates the psychological impact of participating in a pancreatic cancer surveillance program.
  
  
  METHODS
  : High-risk individuals participating in an endoscopic ultrasonography-magnetic resonance imaging-based pancreatic cancer surveillance program received a questionnaire assessing experiences with endoscopic ultrasonography and magnetic resonance imaging, reasons to participate, psychological distress, and benefits and barriers of surveillance. High-risk individuals were individuals with a strong family history of pancreatic cancer or carriers of pancreatic cancer-prone gene mutations.
  
  
  RESULTS
  : Sixty-nine participants (85%) completed the questionnaire. Surveillance was reported as "very to extremely uncomfortable" by 15% for magnetic resonance imaging and 14% for endoscopic ultrasonography. Most reported reason to participate was that pancreatic cancer might be detected in a curable stage. Abnormalities were detected in 27 respondents, resulting in surgical resection in one individual and a shorter follow-up interval in five individuals. Surveillance outcomes did not influence cancer worries. Overall, 29% was "often" or "almost always" concerned about developing cancer. Six respondents (9%) had clinical levels of depression and/or anxiety. According to 88% of respondents, advantages of surveillance outweighed disadvantages.
  
  
  CONCLUSIONS
  : Although endoscopic ultrasonography is more invasive than magnetic resonance imaging, endoscopic ultrasonography was not perceived as more burdensome. Despite one third of respondents worrying frequently about cancer, this was not related to the surveillance outcomes. Anxiety and depression levels were comparable with the general population norms. Advantages of participation outweighed disadvantages according to the majority of respondents. From a psychological point of view, pancreatic cancer surveillance in high-risk individuals is feasible and justified.
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam.
authors.forename: Femme
authors.initials: F
authors.lastname: Harinck
authors.forename: Tanja
authors.initials: T
authors.lastname: Nagtegaal
authors.forename: Irma
authors.initials: I
authors.lastname: Kluijt
authors.forename: Cora
authors.initials: C
authors.lastname: Aalfs
authors.forename: Ellen
authors.initials: E
authors.lastname: Smets
authors.forename: Jan-Werner
authors.initials: JW
authors.lastname: Poley
authors.forename: Anja
authors.initials: A
authors.lastname: Wagner
authors.forename: Jeanin
authors.initials: J
authors.lastname: van Hooft
authors.forename: Paul
authors.initials: P
authors.lastname: Fockens
authors.forename: Marco
authors.initials: M
authors.lastname: Bruno
authors.forename: Eveline M A
authors.initials: EM
authors.lastname: Bleiker
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety; D014408:Biomarkers, Tumor / Q000235:genetics*; D003863:Depression; D055088:Early Detection of Cancer / Q000523:psychology*; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000235:genetics / Q000523:psychology*; D011159:Population Surveillance / Q000379:methods*; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D014408:Biomarkers, Tumor