Clinical characteristics and prognosis of pancreatic ductal adenocarcinoma detected by health checkups versus symptomatic presentation: a retrospective comparative study

Although early detection of pancreatic ductal adenocarcinoma (PDAC) remains challenging, health checkups may improve clinical outcomes. This retrospective study compared the clinical characteristics of PDAC cases identified during health checkups (HC cohort, 61 patients) with those diagnosed through other methods (non-HC cohort, 801 patients). Transabdominal ultrasonography was more frequently used in the HC cohort ( P < 0.01). Patients in the HC cohort were significantly younger ( P < 0.05), had lower carcinoembryonic antigen and carbohydrate antigen 19 − 9 levels, and had smaller tumor sizes ( P < 0.01). Notably, the HC cohort showed significantly higher proportions of stage IA and stage IIA disease and higher rates of curative surgical resection (all P < 0.01). Overall patient survival in the HC cohort was significantly higher than in the non-HC cohort ( P < 0.01 for the log-rank test and multivariable analysis), with a tumor size ≤ 20 mm significantly associated with survival exceeding 5 years in the HC cohort ( P = 0.015). Our findings suggest that health checkups can facilitate earlier PDAC diagnosis and improve long-term prognosis. Thus, standardizing PDAC screening during health checkups, specifically to detect early-stage tumors (≤ 20 mm), could potentially contribute to improving long-term outcomes.