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.[25][74]

High-risk patients are those who:[25][75]​​

  • 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 gene mutation), 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 should begin at age 35 years for people with Peutz-Jeghers syndrome, at age 40 years in CDKN2A and PRSS1 mutation carriers with hereditary pancreatitis, and at age 50 years, or 10 years younger than the initial age of familial onset, for other people at high risk.[25][41]​​[74][75]​​​​​​ According to one meta-analysis, screening of 135 high-risk patients leads to the identification of 1 patient with pancreatic cancer lesion.[76]

The preferred screening tests are magnetic resonance imaging and endoscopic ultrasonography (EUS) in combination.[25][41]​​[75]​​​​​​

Screening is not recommended for patients who are not high risk.[25][77]

Use of this content is subject to our disclaimer