A urine test is shown.
A urine test can detect three proteins found at elevated levels in patients with pancreatic cancer, possibly offering an important new tool in early detection. (For Spectrum Health Beat)

Scientists report that they have developed a urine test that may detect pancreatic cancer at an early stage.


Our Take

According to the American Cancer Society, more than 48,000 people in the U.S. will be diagnosed with pancreatic cancer this year and more than 40,000 individuals will die from the disease.

For medical oncologist Nehal Lakhani, MD, PhD, the potential for an accurate, non-invasive test for early-stage pancreatic cancer is an exciting development, yet still very preliminary.

“We don’t have an accurate screening test for pancreatic cancer—like a mammogram is for breast cancer or a colonoscopy for colorectal cancer,” he said. “A urine test would be ideal because it’s an easy, non-invasive way to get a sample.”

Most pancreatic cancer patients present with symptoms of jaundice, weight loss and pain, Dr. Lakhani said. By this time, the disease is advanced and chance of survival is poor.

If developed, people who could benefit most from a simple, inexpensive pancreatic cancer screening test include those with:

  • Puetz-Jeghers syndrome
  • Hereditary pancreatitis
  • A family history of pancreatic cancer
  • Certain inherited gene mutations that increase risk

Smoking and obesity also contribute to increased risk for pancreatic cancer.

“Each of these modifiable risk factors, in particular, significantly adds to a person’s chance of getting the disease,” Dr. Lakhani said.

Usually, symptoms of this deadly disease do not appear until it is at an advanced stage and has spread, and little can be done to save the patient. Researchers have been looking for a way to screen people for pancreatic cancer in the hopes that early detection might lead to effective treatment.

“If this test proves to be as good as we hope, we could make an important difference and enable early diagnosis of pancreatic cancer completely noninvasively, using urine samples,” said lead researcher Dr. Tatjana Crnogorac-Jurcevic, a reader in cancer genomics at the Centre for Molecular Oncology at Barts Cancer Institute of Queen Mary University of London.

The team found three indicators (“markers”) that, when combined, signal the beginnings of pancreatic cancer.

“This is important since if this cancer is detected early, patients can undergo surgery, which greatly increases the survival,” she said. “At present, patients are diagnosed with cancer that has already spread and survival is typically three to six months.”

The report was published Aug. 3 in the journal Clinical Cancer Research.

For the study, funded by the Pancreatic Cancer Research Fund, a British charity, researchers analyzed 488 urine samples, including 192 from patients with pancreatic cancer, 92 from patients with chronic pancreatitis and 87 from healthy people. In addition, they looked at 117 urine samples from patients with diseases of the liver and gall bladder. These samples were used to confirm their findings.

Of the 1,500 proteins found in the urine samples, Crnogorac-Jurcevic’s team focused on three: LYVE1, REG1A and TFF1.

The researchers found that patients with pancreatic cancer had elevated levels of all three proteins compared with healthy patients and patients with pancreatitis. Using all three proteins, they were able to detect early stage pancreatic cancer more than 90 percent of the time, they reported.

Although the cause of pancreatic cancer isn’t known, those at risk include people with a family history of the disease, heavy smokers, people who are obese and those over 50 with newly diagnosed diabetes, the researchers said.

The team is hoping to do further tests on urine samples from people at high risk to further validate their findings.

Dr. Leonard Lichtenfeld, deputy chief medical officer at the American Cancer Society, said the findings are very preliminary and more research is needed to see if a screening test could be developed based on these three markers.

Among Lichtenfeld’s concerns for any screening test are accuracy, ease and repeatability to find cancer early. “Ultimately, one has to demonstrate that the test really makes a difference in outcomes,” he said.

“I think it’s premature to make a claim that this is an effective screening test,” he said. “This is not something that is going to be available in the near future.”