PhD defence I.J.M. (Iris) Levink

Brief summary of the doctoral thesis:

Pancreatic cancer is a lethal disease, for which timely detection and early surgical resection provide the only chance of cure. In individuals with an increased risk of developing pancreatic cancer (high-risk individuals), including those with a hereditary predisposition or neoplastic pancreatic cyst, surveillance may lead to earlier detection and improved survival. However, it is debatable whether these benefits weigh up to its drawbacks, such as patient anxiety, harm by overtreatment and increased healthcare expenses.

While malignant transformation is difficult to identify with current imaging modalities, (cancer) cells constantly shed various materials to surrounding tissues. We postulate that measuring these substances in blood and pancreatic juice may serve as indicators for high-grade dysplasia or early-stage cancer. The detection of a biomarker signature in blood and pancreatic juice may stratify high-risk individuals by cancer risk and bring forth a surveillance program with tailored intervals and modalities. The ultimate goal of such a marker panel is to detect pancreatic cancer at a curable stage, while minimizing surveillance-related harms.

This thesis critically appraises current recommendations for pancreas surveillance (PART I) and evaluates the potential of biomarker analysis in blood and pancreatic juice (PART II).