Screening

High-risk group

Screening, genetic testing, and genetic counselling should be considered for patients at high risk. Patients eligible for screening should be referred to a specialist centre or encouraged to participate in a registry.[23][25]​​

High-risk patients are those who:[25][73]​​

  • Are first-degree relatives of patients with pancreatic cancer and have at least two affected genetically related relatives

  • Have a genetic syndrome associated with an increased risk of pancreatic cancer. This includes all patients with hereditary pancreatitis (PRSS1, SPINK1, and other gene mutations), Peutz-Jehgers syndrome, or familial atupical multiple mole melanoma syndrome (CDKNA gene mutation); and patients with one more first-degree relatives with pancreatic cancer with Lynch syndrome or mutations in BRCA1, BRCA2, PALB2, or ATM genes.

Screening considerations:[23][25][41]​​​​[73]​​​​​​​

  • Individuals with Peutz-Jeghers syndrome: start screening between aged 30 and 35 years, or 10 years younger than the initial age of familial onset.

  • CDKN2A mutation carriers: start screening at 40 years, or 10 years younger than the initial age of familial onset.

  • ATM or BRCA2 mutation carriers and other people at high risk: start screening at 50 years, or 10 years younger than the initial age of familial onset.

  • Individuals with hereditary pancreatitis: start screening 20 years after onset of pancreatitis, or at age 40 years, whichever is earlier.

According to one meta-analysis, screening of 135 high-risk patients leads to the identification of 1 patient with pancreatic cancer lesion.[74]

The preferred screening tests are magnetic resonance imaging and endoscopic ultrasonography (EUS) in combination.[25][41]​​[73]​​​​​​

Screening is not recommended for patients who are not high risk.[25][75]

Use of this content is subject to our disclaimer