# The Multicenter Cancer of Pancreas Screening Study: Impact on Stage and Survival

Source: https://onco.cc/key-papers/paper-dbouk-caps5-stage-survival-jco-2022/  
OnCo record `paper-dbouk-caps5-stage-survival-jco-2022` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The 2022 report from eight US centres: among 1,461 people at high inherited risk under regular scanning, most pancreatic cancers were caught at stage I, and across all the CAPS cohorts patients whose cancer was found by surveillance lived a median of nearly ten years against a year and a half for those found outside it.

## Summary

Dbouk, Goggins and colleagues report the CAPS5 study, 1,461 high-risk individuals enrolled at eight centres between 2014 and 2021, 48.5 percent with a pathogenic variant in a susceptibility gene. Ten were diagnosed with pancreatic cancer, one metastatic four years after leaving surveillance; of the other nine, seven (77.8 percent) were stage I by surgical pathology, one stage II and one stage III, and seven of nine were alive at a median of 2.6 years. Eight more had surgery for worrisome lesions (three high-grade, five low-grade dysplasia). Across CAPS1 to CAPS5 (1,731 patients), 26 cancers were diagnosed, 19 within surveillance, 57.9 percent stage I and 5.2 percent stage IV, against six of seven (85.7 percent) stage IV among cancers found outside surveillance. Five-year survival of screen-detected cancer was 73.3 percent and median overall survival 9.8 years, against 1.5 years outside surveillance (hazard ratio 0.13, 95 percent confidence interval 0.03 to 0.50, P = 0.003).

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Tags: pancreatic-evidence
- Journal: Journal of Clinical Oncology
- Year: 2022
- DOI: 10.1200/JCO.22.00298
- Authors: Dbouk M, Katona BW, Brand RE, et al.
- Findings: 1,461 high-risk individuals at eight centres; 7 of 9 surveillance-detected cancers were stage I.; Across CAPS1 to 5 (1,731 patients): 57.9 percent of surveillance-detected cancers stage I, 5.2 percent stage IV; 85.7 percent of cancers found outside surveillance stage IV.; Five-year survival 73.3 percent and median survival 9.8 years for screen-detected cancer versus 1.5 years outside surveillance (hazard ratio 0.13).
- What it means: The stage shift the pancreatic cancer page quotes (about three in four surveillance-detected cancers at stage I) and the strongest argument for offering surveillance to every germline carrier found by universal testing, which the NHS does not yet do outside research.
- Caveats: Observational; the comparison with cancers found outside surveillance is subject to lead-time, length-time and selection bias.; Nine surveillance-detected cancers in CAPS5; the absolute yield is low and the cost per cancer found is high.

## Sources

- J Clin Oncol 2022: https://doi.org/10.1200/JCO.22.00298
- PubMed: https://pubmed.ncbi.nlm.nih.gov/35704792/

## Connected records

- key papers: [Association Between Inherited Germline Mutations in Cancer Predisposition Genes and Risk of Pancreatic Cancer](https://onco.cc/key-papers/paper-hu-germline-mutations-pancreatic-cancer-risk-jama-2018/), [Management of patients with increased risk for familial pancreatic cancer: updated recommendations from the International Cancer of the Pancreas Screening (CAPS) Consortium](https://onco.cc/key-papers/paper-caps-consortium-surveillance-recommendations-gut-2020/), [Risk of Neoplastic Progression in Individuals at High Risk for Pancreatic Cancer Undergoing Long-term Surveillance](https://onco.cc/key-papers/paper-canto-caps-long-term-surveillance-gastroenterology-2018/)
- cancers: [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/), [Resectable pancreatic ductal adenocarcinoma](https://onco.cc/cancers/resectable-pdac/)
- technologies: [Germline (hereditary) testing](https://onco.cc/technologies/germline-testing/), [High-risk pancreatic surveillance (CAPS / PRECEDE)](https://onco.cc/technologies/pancreatic-surveillance/), [MRI](https://onco.cc/technologies/mri/)
- institutions: [Abramson Cancer Center, University of Pennsylvania](https://onco.cc/institutions/penn-abramson/), [Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center](https://onco.cc/institutions/johns-hopkins/), [UPMC Hillman Cancer Center](https://onco.cc/institutions/upmc-hillman/)
- terms: [CAPS: the Cancer of the Pancreas Screening consortium and its surveillance studies (CAPS1 to CAPS5)](https://onco.cc/terms/caps-consortium-pancreatic-screening/), [Hazard ratio (HR)](https://onco.cc/terms/hazard-ratio/), [Overall survival (OS)](https://onco.cc/terms/os/)
- trials: [PRECEDE](https://onco.cc/trials/precede/)
- bottlenecks: [Inherited risk is mostly unidentified](https://onco.cc/bottlenecks/b-hereditary-risk/), [The hardest cancers are found late](https://onco.cc/bottlenecks/b-early-detection/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)
- roadmaps: [Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question](https://onco.cc/roadmaps/pancreatic-roadmap/)
- ideas: [Surveillance for every germline carrier found by universal testing, inside a registry rather than a research exception](https://onco.cc/ideas/idea-pdac-surveillance-for-every-germline-carrier/)

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