Observational Registry Evaluating the Clinical Impact of the Blood-Based Biomarker Test for Early-Stage Pancreatic Ductal Adenocarcinoma

This observational registry designed to evaluate the impact of PancreaSure, a blood-based biomarker test, on the management of pancreatic cancer surveillance in individuals at high risk for pancreatic ductal adenocarcinoma. The study aims to understand how the test results influence clinical decisions, such as whether doctors escalate, maintain, or de-escalate surveillance plans for patients. The study will also assess how the test is used in real-world clinical settings, its impact on healthcare utilization, and patient-reported outcomes like anxiety, satisfaction, and understanding of test results.

The study will enroll a minimum of 400 high-risk individuals aged 45 or older who are part of a recognized pancreatic surveillance programs for whom the PancreaSure test is ordered as part of routine clinical care. Participants will be followed for up to 24 months, with key assessments occurring 7-14 days after the test results are returned, and again at 12 and 24 months. The primary objective is to evaluate changes in clinician decision-making regarding surveillance management following receipt of PancreaSure test results, stratified by positive versus negative findings. Secondary objectives include analyzing how often the test is ordered, how it affects follow-up imaging, and how the patients perceive the test's impact on their care. Exploratory objectives will look at the clinical outcomes, such as the stage of cancer at diagnosis and the economic impact of using the test.

The study does not introduce experimental interventions, and all medical decisions remain at the discretion of the treating clinicians.

Inclusion criteria

• Able to provide informed written consent and complete the survey in English or Spanish
• >45 years of age
• PancreaSure ordered as part of routine clinical care.
• At elevated risk for PDAC or is deemed appropriate for PDAC early detection testing based on:

• Family history in ≥ 2 first-degree relatives, or
• Known pathogenic germline mutation (BRCA1/2, CDKN2A, PALB2, ATM, STK11, PRSS1), or
• Pancreatic cystic lesion, or
• New-onset diabetes with additional risk factors, or
• Clinician discretion

Exclusion criteria

• Prior diagnosis of PDAC or other active malignancy within 3 years (except non-melanoma skin cancer).
• Participation in interventional investigational studies that may bias test use.
• Inability or unwillingness to comply with follow-up schedule.