PhD defence K.A. (Kasper) Overbeek

Summary:

This thesis describes scientific research on several aspects of pancreatic cancer surveillance. The goal of surveillance is to detect the disease in an early stage. The thesis consists of ten studies that are divided over three parts.

The first part is aimed at identifying the ideal target populations, including diabetes mellitus patients, patients with a pancreatic cyst, and individuals with an inherited predisposition for pancreatic cancer. A model was developed that estimates the risk of a cyst to develop high-risk features. In addition, recommendations are made on which types of inherited predisposition make an individual eligible for surveillance.

The second part is dedicated to the psychological burden of surveillance and its potential harms for participants. In summary, participants deem the burden to be low, and the advantages to outweigh the disadvantages. Even participants who had experienced negative effects of surveillance, had an unchanged and positive opinion of surveillance.

The third part covers long-term outcomes of surveillance. After 13 years, pancreatic cancer was detected in multiple individuals with a strong inherited predisposition, but not in individuals without. Despite surveillance, most cases of pancreatic cancer were detected in an advanced stage. In almost half of the cases, pancreatic cancer seemed to have arisen from a pancreatic cyst. Cysts in individuals with an inherited predisposition seem to have a higher growth speed and a higher risk to develop high-risk features, than cysts in individuals without inherited predisposition.