Factors influencing the diagnostic basis in pancreatic cancer. A study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Year: 2025

Type: article

Abstract: BACKGROUND AND AIMS: Substantial differences have been reported in risk estimates for etiologic factors of pancreatic cancer among subjects with different degrees of diagnostic certainty. The aim of the study was to assess the influence of some personal and social characteristics on the diagnostic basis in individuals with pancreatic cancer. METHODS: We analyzed 393 participants from the EPIC cohort with a diagnosis of pancreatic cancer and information on the basis of diagnosis. Two main groups of cases were compared: one in which microscopic confirmation (MC) was available to diagnose pancreatic cancer (including autopsy, histology, cytology or hematology), and one in which non-microscopic methods were used (biochemical, immunological or image tests, exploratory surgery, clinical observation, self-report, or death certificate). RESULTS: The diagnosis of pancreatic cancer of 73% of participants was achieved through MC. While, overall, over 82% of men had MC, this figure was 65% in women (p<0.001). Subjects with MC, both men and women, were younger at diagnosis than participants diagnosed by non-microscopic methods. Younger women (<60 years) had a higher probability of having their cancer diagnosed with MC (OR=2.54, 95% CI 1.04-6.17) than women ≥70 years. After the year 2000 the chances of having the disease diagnosed through MC increased more than 2-fold in women and more than 5-fold in men. No significant differences in diagnostic basis were observed by educational level, comorbidities or established risk factors for pancreatic cancer. CONCLUSION: The rates of MC in subjects diagnosed with pancreatic cancer continued to be relatively low. Age and sex are the two main factors that powerfully influence MC. Hence, age and sex must be considered when designing and analyzing clinical and epidemiological studies, as well as in clinical practice. The consistently lower rates of MC in female patients suggest an ingrained sex-related diagnostic bias, which may require specific policies to be counterbalanced.

Source: Cancer Treatment and Research Communications

DOI: 10.1016/j.ctarc.2025.101009

Institutions: Universitat Autònoma de Barcelona, Universitat Pompeu Fabra, Hospital Del Mar, Municipal Institute for Medical Research, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Hospital del Mar Research Institute, University of Copenhagen, Instituto Murciano de Investigación Biosanitaria, Università degli Studi del Piemonte Orientale “Amedeo Avogadro”, Aarhus University, Institut d'Investigació Biomédica de Bellvitge, Institut Català d'Oncologia, Fondazione IRCCS Istituto Nazionale dei Tumori, Inserm, Université de Versailles Saint-Quentin-en-Yvelines, Centre de recherche en Epidémiologie et Santé des Populations, Université Paris-Saclay, Institut Gustave Roussy, University of Florence, University of Oxford, Instituto de Salud Pública de Navarra, University of Naples Federico II, Associazione Iblea per la Ricerca Epidemiologica E.T.S., Instituto de Investigación Biosanitaria de Granada, Andalusian School of Public Health, Basque Government, Biogipuzkoa Health Research Institute, Centre international de recherche sur le cancer, Italian institute for Genomic Medicine, Imperial College London, German Cancer Research Center

Language: English

Topic: Pancreatic and Hepatic Oncology Research

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,740

Funders: Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Foundation for Iranian Studies, World Health Organization, Compagnia di San Paolo, Universitetet i Tromsø, Kræftens Bekæmpelse, Deutsches Krebsforschungszentrum, Fundació la Marató de TV3, Centre International de Recherche sur le Cancer, Skåne County Council's Research and Development Foundation, Cancer Research UK, National Institute for Health and Care Research, Imperial College London, European Commission, Agence Nationale de la Recherche, Institut National de la Santé et de la Recherche Médicale, ZonMw, Bundesministerium für Bildung und Forschung, Cancerfonden, Generalitat de Catalunya, Ministerie van Volksgezondheid, Welzijn en Sport, Ministero della Salute, Ligue Contre le Cancer, Vetenskapsrådet, Ministère de l'Education Nationale, de l'Enseignement Superieur et de la Recherche, Associazione Italiana per la Ricerca sul Cancro, Deutsche Krebshilfe, Institut Gustave-Roussy, Mutuelle Générale de l'Education Nationale, Fonds de Recherche en Santé Respiratoire, Junta de Andalucía, Ministero dell'Università e della Ricerca, Rollins School of Public Health, Medical Research Council, World Cancer Research Fund, Instituto de Salud Carlos III, European Regional Development Fund, NIHR Imperial Biomedical Research Centre, School of Public Health, Imperial College London, Department of Epidemiology and Biostatistics, University of California, San Francisco

OpenAlex ID: W4414568967