Pancreas Team

Lab PI: Mary Linton B. Peters, MD, MS, FACP

Pancreatic adenocarcinoma is a highly lethal malignancy, most often diagnosed at a late stage when it is no longer surgically resectable. There is significant interest in methods of earlier detection or prevention to increase survival, but unfortunately, pancreatic cancer risk factors have been challenging to identify. Our team has developed a microsimulation model of the development of pancreatic cancer from both cystic and solid pre-cancerous states (see figure below). We use this model to ask research questions including:

  • How can we use germline genetic testing to identify high-risk family members who would benefit from screening?
  • When should screening for pancreatic cancer start, and how often should it be performed, for people at various risk of the disease?
  • How cost-effective is screening for pancreatic cancer?
We have developed a microsimulation model of the natural history of pancreatic ductal adenocarcinoma (PDAC).  The model, written in C++, simulates cohorts of hypothetical subjects from age 40 until death.  Each cohort is assigned a relative risk of PDAC.  During each model cycle (one month), a simulated subject may transition to a new health state (e.g., from PanIn3 to undetected cancer).  Any unobservable probabilities of transition are calibrated using observable targets obtained from SEER data and the published literature.  Cystic and solid pathways to PDAC are modeled separately. The simulation model is recalibrated at each PDAC risk level, to match corresponding risks (calibration targets) of PDAC development and death.


Peters, Mary Linton B; Eckel, Andrew; Seguin, Claudia L; Davidi, Barak; Howard, David H; Knudsen, Amy B; Pandharipande, Pari V

Cost-Effectiveness Analysis of Screening for Pancreatic Cancer Among High-Risk Populations Journal Article

In: JCO Oncol Pract, vol. 20, iss. 2, pp. 278-290, 2024, ISSN: 2688-1535.

Abstract | Links | BibTeX


Peters, Mary Linton B.; Eckel, Andrew; Lietz, Anna; Seguin, Claudia; Mueller, Peter; Hur, Chin; Pandharipande, Pari V.

‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬Genetic testing to guide screening for pancreatic ductal adenocarcinoma: Results of a microsimulation model Journal Article

In: Pancreatology, vol. 22, iss. 6, pp. 760-769, 2022, ISSN: 1424-3903.

Abstract | Links | BibTeX


Weaver, Davis; Lietz, Anna; Mercaldo, Sarah Fletcher; Peters, Mary Linton B.; Hur, Chin; Kong, Chung Yin; Wolpin, Brian M; Megibow, Alec J; Berland, Lincoln L; Knudsen, Amy; Pandharipande, Pari

Testing for Verification Bias in Reported Malignancy Risks for Side-Branch Intraductal Papillary Mucinous Neoplasms: A Simulation Modeling Approach. Journal Article

In: AJR. American journal of roentgenology, vol. 212, no. 3, pp. 596-601, 2019, ISSN: 1546-3141.

Abstract | Links | BibTeX


Peters, Mary Linton B.; Eckel, Andrew; Mueller, Peter P.; Tramontano, Angela; Weaver, Davis; Lietz, Anna; Hur, Chin; Kong, Chung Yin; Pandharipande, Pari

Progression to pancreatic ductal adenocarcinoma from pancreatic intraepithelial neoplasia: Results of a simulation model. Journal Article

In: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], vol. 18, no. 8, pp. 928-934, 2018, ISSN: 1424-3911.

Abstract | Links | BibTeX


Pandharipande, Pari; Jeon, Alvin; Heberle, Curtis; Dowling, Emily; Kong, Chung Yin; Chung, Daniel C.; Brugge, William R.; Hur, Chin

Screening for Pancreatic Adenocarcinoma in BRCA2 Mutation Carriers: Results of a Disease Simulation Model Journal Article

In: EBioMedicine, vol. 2, no. 12, pp. 1980–1986, 2015.

Abstract | Links | BibTeX


Pandharipande, Pari; Heberle, Curtis; Dowling, Emily; Kong, Chung Yin; Tramontano, Angela; Perzan, Katherine; Brugge, William; Hur, Chin

Targeted Screening of Individuals at High Risk for Pancreatic Cancer: Results of a Simulation Model Journal Article

In: Radiology, vol. 275, no. 1, pp. 177-87, 2014.

Abstract | Links | BibTeX