FTP7.5 Accuracy of the END-PAC model in predicting the risk of developing pancreatic cancer in patients with new-onset diabetes: a systematic review and meta-analysis

Abstract

Abstract Objectives to evaluate the accuracy of END-PAC model in predicting the risk of pancreatic cancer in patients with new-onset diabetes (NOD). Methods A systematic review in accordance with PRISMA statement standards was conducted to identify all studies evaluating the accuracy of END-PAC model in predicting the risk of pancreatic cancer in patients with NOD. The number of true positives, false negatives, true negatives, and false positives were used to construct two-by-two tables, coupled forest plots and the summary receiver operating characteristic plots. We estimated summary sensitivity and specificity points using diagnostic random effects model. Results We analysed 26752 patients from four studies. The pooled risk of pancreatic cancer was 0.8% (95% CI 0.6%-1.0%) with median follow-up of 3 years. END-PAC score ≥3 [sensitivity: 55.8% (43.9%-67%); specificity: 82.0% (76.4%-86.5%)] which classifies the patients as high risk was associated with better predictive performance than END-PAC score 1–2 [sensitivity: 22.2% (16.6%-29.2%); specificity: 69.9% (67.3%-72.4%)] and END-PAC score <1 [sensitivity: 18.0% (12.8%-24.6%); specificity: 50.9% (48.6%-53.2%)] which classify the patients as intermediate and low risks, respectively. The quality of the available evidence was moderate to high. Conclusions END-PAC model is promising in predicting the risk of pancreatic cancer in patients with new-onset diabetes. END-PAC score ≥3, which classifies the patients as high risk, has the best predictive performance and should be considered as optimum cut-off value. Future comparative studies are required to evaluate whether application of END-PAC model could improve pancreatic cancer early detection rate, pancreatic cancer resection rate, and pancreatic cancer treatment outcomes.