PhD Defence Brechtje Koopmann

Short description of thesis:

This thesis investigates the potential effectiveness of pancreatic cancer surveillance. In the first part, we used our microsimulation model to evaluate the impact of several uncertainties (e.g. pancreatic cancer risk, natural disease course) on surveillance effectiveness. We adjusted our microsimulation model to gain insight into the natural disease course of pancreatic cancer and found a 4 year window of opportunity for HGD detection. In the second part, we evaluated the maximum effect of pancreatic cyst surveillance and found a number needed to surveil so high that cyst surveillance seems inefficient with currently used expensive and burdensome tests. In the third part, dedicated to individuals with a hereditary increased pancreatic cancer risk, we performed a clinical surveillance study of high risk individuals. Finally, we used our microsimulation model to evaluate long-term effectiveness of pancreatic cancer surveillance in CDKN2A mutation carriers.