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Journal of Gastrointestinal Surgery

, Volume 16, Issue 4, pp 771–783 | Cite as

Screening for Pancreatic Cancer in a High-Risk Cohort: An Eight-Year Experience

  • Wigdan Al-Sukhni
  • Ayelet Borgida
  • Heidi Rothenmund
  • Spring Holter
  • Kara Semotiuk
  • Robert Grant
  • Stephanie Wilson
  • Malcolm Moore
  • Steven Narod
  • Kartik Jhaveri
  • Masoom A. Haider
  • Steven Gallinger
Original Article

Abstract

Background

Pancreatic adenocarcinoma is the fourth leading cause of cancer death.

Methods

A prospective cohort study was undertaken between 2003 and 2011 at a tertiary care centre in Toronto, Canada. Two hundred and sixty-two subjects were enrolled based on an elevated estimated lifetime risk for pancreatic cancer due to known genetic mutations and/or cancer family history. Subjects underwent annual magnetic resonance imaging, followed by additional investigations if abnormal findings were detected. Evidence of malignancy or suspicious macroscopic abnormalities prompted referral for surgical intervention.

Results

Average length of follow-up was 4.2 years, during which 84/262 (32%) subjects demonstrated pancreatic abnormalities. Three participants developed pancreatic adenocarcinoma (one 1.5-cm tumor was resected but recurred, while the other two subjects developed metastatic cancer), and a fourth participant developed a pancreatic neuroendocrine tumor that was resected. Fifteen subjects had radiologic evidence of branch-duct intraductal papillary mucinous neoplasms, of which two underwent surgical resection. Sixty-five subjects had simple pancreatic cysts that have remained stable.

Conclusion

Magnetic resonance imaging can detect small pancreatic tumors and cystic lesions, but further improvement in sensitivity is needed. An understanding of the natural history of pre-invasive lesions in members of high-risk families is necessary for developing a more effective screening program.

Keywords

Familial pancreatic cancer Screening Magnetic resonance imaging Intraductal papillary mucinous neoplasms 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2011

Authors and Affiliations

  • Wigdan Al-Sukhni
    • 1
  • Ayelet Borgida
    • 2
  • Heidi Rothenmund
    • 2
  • Spring Holter
    • 2
  • Kara Semotiuk
    • 2
  • Robert Grant
    • 1
  • Stephanie Wilson
    • 3
  • Malcolm Moore
    • 4
  • Steven Narod
    • 5
  • Kartik Jhaveri
    • 3
  • Masoom A. Haider
    • 3
  • Steven Gallinger
    • 1
    • 2
    • 6
  1. 1.Hepatobiliary/Pancreatic Surgical Oncology Program, Division of General Surgery, Department of SurgeryUniversity Health Network, University of TorontoTorontoCanada
  2. 2.Familial Gastrointestinal Cancer Registry, Mount Sinai HospitalUniversity of TorontoTorontoCanada
  3. 3.Department of Medical ImagingUniversity Health Network, University of TorontoTorontoCanada
  4. 4.Division of Medical Oncology and Hematology, Department of MedicineUniversity Health Network, University of TorontoTorontoCanada
  5. 5.Women’s College Research InstituteUniversity of TorontoTorontoCanada
  6. 6.Toronto General HospitalTorontoCanada

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