gms | German Medical Science

Background: The early detection of pancreatic cancer plays a key role in reducing mortality by offering patients curative treatment. Screening strategies in risk populations have been economically evaluated to guide resource allocation towards early detection within the disease area.

Objective: A synthesis of studies to understand economic aspects of early pancreatic cancer detection should thus be conducted.

Methods: A systematic literature search of the databases Medline, Web of Science, and EconLit for economic evaluations reporting the cost-effectiveness or costs of pancreatic cancer screening, yielded articles accepted between June 19th, 1989 and September 6th, 2023. Information on costs and general study characteristics was extracted. Two independent reviewers will assess the reporting quality and risk of bias using the Consolidated Health Economic Evaluation Reporting Standards statement and the Bias in Economic Evaluation checklist, respectively.

Results: The literature review included 27 studies on economic aspects of pancreatic cancer screening. The majority of studies was classified as full (n = 20) and the remaining as partial economic evaluations. A wide variety in methodological approaches was shown in terms of screening methods, screened individuals and study conclusions. All studies provided input costs for pancreatic cancer screening. The most widely used clinical outcome measure were quality-adjusted life years (n = 18). The majority of full economic evaluations were model-based (n = 19/20), applied a third-party perspective (n = 13/20), and simulated a lifetime horizon (n = 13/20). The conditions for individuals to be screened were ambiguous, as half of the studies evaluated the screening of asymptomatic risk groups (n = 14) and the remaining studies either confirmed previously found pancreatic lesions or retrospectively evaluated patient cohorts. On average, the reporting quality was 71%, while the scores ranged from 36% to 93%.

Implication for research: The number of economic evaluations in pancreatic cancer screening has visibly increased in the last decade. Nevertheless, there is a growing need for evaluations of screening methods, identification of appropriate risk groups and updated cost studies. In parallel with the current research on new screening methods, strategies for the early detection of pancreatic cancer must be developed that meet the economic and ethical principles of healthcare systems. All included studies met the ethical criterion of only screening individuals with an elevated risk of pancreatic cancer and addressed the issue of efficient resource use in pancreatic cancer care. Findings on the study quality may guide improvement in overall study quality for future economic evaluations in pancreatic cancer screening.

Funding: Other funding; Project name: PANCAID (PANcreatic CAncer Initial Detection via liquid biopsy); Grant number: Horizon Europe ID: 101096309