Breakthrough blood tests offer hope in early pancreatic cancer detection

CLEVELAND, Ohio — Pancreatic cancer stands apart from many common cancers for a troubling reason: There is no standard screening test to catch the disease early, when treatment is most effective.

That has led to a detection gap with deadly consequences for Ohioans, as the disease remains invisible in its early stages, experts say.

But researchers believe there is hope on the horizon. The Grail Galleri blood test can screen for more than 50 cancer types, including pancreatic cancer, though it is not yet covered by most insurance plans or considered standard care.

The test screens asymptomatic people over 50 years of age, detecting cancer in about 1 in 200 cases, according to researchers. For those with new symptoms, the detection rate rises to 1 in 20.

“If you detect it early enough, then the cure rate can be as high as 20%,” said Dr. Jordan Winter, a pancreatic cancer specialist at University Hospitals Seidman Cancer Center.

From 2017 to 2021, an average of 2,168 cases of pancreatic cancer were diagnosed annually in Ohio, ranking it as the third leading cause of cancer death in the state.

During that same period, the disease claimed an average of 1,899 lives per year, according to data from the Ohio Department of Health.

According to a report from the American Cancer Society, an estimated 67,440 patients are expected to be diagnosed with pancreatic cancer in 2025. Yet nearly 52,000 people are expected to die from the disease.

The numbers reflect the challenge. Only 11 percent of Ohioans with pancreatic cancer survive five years after diagnosis, consistent with the national average, according to ODH. Approximately 60 to 70 percent of cases are diagnosed at late stages when surgery is no longer possible, Dr. Winter added.

“We can correlate that to both the lack of an early detection test as well as poor treatment options,” Winter said.

The pancreas is a 6-inch-long gland located between the stomach and spine. It produces juices that break down food and hormones like insulin and glucagon that control blood sugar levels. When cancer is detected early and has not spread, surgery can cure the disease.

But most cases are found at advanced stages, when doctors can only aim to control cancer and improve quality of life.

Part of the problem is that symptoms are vague and easily mistaken for other conditions. Patients may experience a deep, dull ache in the abdomen, weight loss or new-onset diabetes. Symptoms can also include jaundice, itchy skin, greasy or clay-colored stools and dark urine.

“Pancreas cancer often presents with very non-specific symptoms that typically are caused by other underlying processes other than pancreas cancer,” Winter said.

The disease primarily affects older adults in their 60s and 70s, though it can occur in people as young as 30. Risk factors include smoking, chronic pancreatitis, obesity and family history. Having one close relative with pancreatic cancer triples the relative risk; having two relatives increases it sixfold.

Black individuals have the highest incidence and mortality rates, though experts have not determined why, according to government data.

In Ohio, Cuyahoga County experienced the highest incidence rates from 2017 to 2021, with 255 cases and 235 deaths on average per year. Franklin County followed with 188 cases and 158 deaths per year. Hamilton and Summit counties also saw high incidence and mortality rates in connection with the disease.

The figures show the need for early detection.

“There’s a lot of hope for people who have it detected early enough and are getting surgery for pancreatic cancer,” Winter said.

Winter is the director of the Winter Lab at Case Comprehensive Cancer Center, which aims to study effective therapies for pancreatic cancer.

Clinical trials are exploring KRAS inhibitors, which target a gene activated in almost all pancreatic cancers, and vaccines designed to prevent recurrence after surgery. Winter encourages those being treated for the disease to participate in the trials.

“Consideration for clinical trials is so important because those trials may help their loved one, but they also help us learn more about how to treat this disease better so that we can have a different solution, a better solution for people in the future than we have today,” Winter said.

Those interested in supporting efforts to help with pancreatic cancer research are also encouraged to participate in events like the PurpleStride in April to help raise awareness and resources to fight the disease.