Routine CT Body Composition Tool Helps Identify Early Pancreatic Cancer Risk

Pancreatic ductal adenocarcinoma (PDAC), the most common type of pancreatic cancer, often goes undetected until it has spread. Surveillance programs primarily target people with inherited genetic risk or strong family histories, yet most cases occur outside these groups. This limits opportunities for early detection in the broader population. A new study suggests that routine CT scans could offer earlier clues by revealing body composition changes years before diagnosis.

Mayo Clinic researchers evaluated whether changes in body composition visible on abdominal CT scans could help identify patients who later developed pancreatic ductal adenocarcinoma (PDAC). The study included Mayo Clinic sites in Arizona, Florida, and Minnesota and analyzed scans from 1,825 patients with PDAC and 3,650 matched controls. According to the researchers, it was the largest controlled study to examine prediagnostic body composition trajectories in this setting.

Using an artificial intelligence-based body composition tool, the team measured skeletal muscle, subcutaneous fat, and visceral fat over time. Patients who later developed PDAC showed steeper declines in both visceral and subcutaneous fat during the three years before diagnosis than matched controls, while differences in muscle mass became most apparent during the final 12 months before diagnosis.

The researchers also evaluated whether longitudinal changes in muscle and fat measurements could distinguish patients who later developed pancreatic cancer from those who did not. These measures showed moderate discriminatory ability. Published in Pancreatology on September 25, 2026, the findings suggest that body composition information extracted from routinely acquired CT scans could contribute to future pancreatic cancer risk assessment strategies.

The Mayo Clinic team is now working on algorithms that combine body composition measurements with other routinely collected clinical factors and imaging biomarkers. These tools are being developed to identify patients at increased risk. The work points to a possible role for routine imaging data in earlier pancreatic cancer risk detection.

“Pancreatic cancer often develops silently, making early detection extremely challenging. These findings suggest that routine CT scans may capture physiological changes associated with pancreatic cancer before patients are diagnosed,” said Yan Bi, M.D., Ph.D., a gastroenterologist at Mayo Clinic and senior author of the study.

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