The Pancreatic Cancer Early Detection (PRECEDE) Study is a Global Effort to Drive Early Detection: Baseline Imaging Findings in High-Risk Individuals

BACKGROUND

Pancreatic adenocarcinoma (PC) is a highly lethal malignancy with a survival rate of only 12%. Surveillance is recommended for high-risk individuals (HRIs), but it is not widely adopted. To address this unmet clinical need and drive early diagnosis research, we established the Pancreatic Cancer Early Detection (PRECEDE) Consortium.

METHODS

PRECEDE is a multi-institutional international collaboration that has undertaken an observational prospective cohort study. Individuals (aged 18-90 years) are enrolled into 1 of 7 cohorts based on family history and pathogenic germline variant (PGV) status. From April 1, 2020, to November 21, 2022, a total of 3,402 participants were enrolled in 1 of 7 study cohorts, with 1,759 (51.7%) meeting criteria for the highest-risk cohort (Cohort 1). Cohort 1 HRIs underwent germline testing and pancreas imaging by MRI/MR-cholangiopancreatography or endoscopic ultrasound.

RESULTS

A total of 1,400 participants in Cohort 1 (79.6%) had completed baseline imaging and were subclassified into 3 groups based on familial PC (FPC; n=670), a PGV and FPC (PGV+/FPC+; n=115), and a PGV with a pedigree that does not meet FPC criteria (PGV+/FPC-; n=615). One HRI was diagnosed with stage IIB PC on study entry, and 35.1% of HRIs harbored pancreatic cysts. Increasing age (odds ratio, 1.05; P<.001) and FPC group assignment (odds ratio, 1.57; P<.001; relative to PGV+/FPC-) were independent predictors of harboring a pancreatic cyst.

CONCLUSIONS

PRECEDE provides infrastructure support to increase access to clinical surveillance for HRIs worldwide, while aiming to drive early PC detection advancements through longitudinal standardized clinical data, imaging, and biospecimen captures. Increased cyst prevalence in HRIs with FPC suggests that FPC may infer distinct biological processes. To enable the development of PC surveillance approaches better tailored to risk category, we recommend adoption of subclassification of HRIs into FPC, PGV+/FPC+, and PGV+/FPC- risk groups by surveillance protocols.

Association of Malnutrition Measures with the Risk of Malaria in Sierra Leone

Objectives

This study examined the relationship between malnutrition and malaria among children under five in Sierra Leone. It was predicted that children who displayed anthropometric indicators for malnutrition (stunting, wasting, underweight) would be at a higher risk for contracting malaria than children who did not.

Methods

Data on height, weight, malaria status and use of malaria prevention measures were collected from patients aged 1 month to 60 months at Magbenteh Community Hospital in Makeni, Sierra Leone using a survey in July 2019 (n = 153). Multivariate regression models were used in order to determine the association between nutritional status and risk of contracting malaria.

Results

Participants who were underweight were found to be 18.56% more likely to contract malaria (p-value = 0.029). Non-statistically significant positive correlations were also found between stunting and risk of contracting malaria (7.15% more likely, p-value = 0.446) and wasting and risk of contracting malaria (5.82% more likely, p-value = 0.528).

Conclusions

The outcomes of this study would contribute to a better understanding of the risk factors for malaria and the relationship between nutritional status and malaria. Understanding this relationship is essential for developing public health interventions in geographic locations where these conditions co-exist.

Funding Sources

N/A.