# AI that spots pancreatic cancer on scans taken a year before diagnosis

Source: https://onco.cc/ideas/idea-prev-pancreas-ai-prediagnostic-ct/  
OnCo record `idea-prev-pancreas-ai-prediagnostic-ct` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Pancreatic cancer is often visible in hindsight on earlier scans. Software trained on those pre-diagnostic scans could flag subtle changes while surgery is still possible.

## Summary

Retrospective studies (Mayo Clinic, Johns Hopkins FELIX project) show deep learning detects pancreatic cancer on pre-diagnostic CTs 3-36 months before clinical diagnosis with high AUC. Propose training on multi-institution pre-diagnostic scan cohorts and prospective deployment on abdominal CTs of patients over 50 with new-onset diabetes or weight loss.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Prospective deployment in high-risk CT populations detects resectable (stage I-II) pancreatic cancer in at least half of flagged true positives, versus roughly 15% resectable at usual diagnosis.
- Rationale: Pancreatic cancer survival is stage-dependent and the pre-diagnostic window is documented; incidence in new-onset diabetes over 50 (about 1%) is high enough to justify targeted use.
- Proposed test: Prospective cohort of 20,000 abdominal CTs in the target population, with two-year registry follow-up for sensitivity and PPV.
- Maturity: preclinical-evidence
- Actor: research

## Sources

- Bottleneck evidence (The hardest cancers are found late): Crosby et al., Early detection of cancer (Science 2022): https://doi.org/10.1126/science.aay9040

## Connected records

- cancers: [Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors](https://onco.cc/cancers/ipmn-cystic-precursors/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/), [Imaging](https://onco.cc/fronts/imaging/)
- technologies: [AI in radiology](https://onco.cc/technologies/radiology-ai-screening/), [CT (computed tomography)](https://onco.cc/technologies/ct/)
- institutions: [Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center](https://onco.cc/institutions/johns-hopkins/), [Mayo Clinic](https://onco.cc/institutions/mayo-clinic/)
- bottlenecks: [The hardest cancers are found late](https://onco.cc/bottlenecks/b-early-detection/)
- key papers: [Early detection of cancer](https://onco.cc/key-papers/paper-crosby-science/)

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