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Evaluation and Surveillance Strategies for Patients at Increased Risk of Pancreatic Cancer

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Pancreatic Masses

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Abstract

Pancreatic adenocarcinoma is a leading cause of cancer death due to the typical late stage at diagnosis, which results in few patients being candidates for potentially curative treatment. Although most cases of pancreatic adenocarcinomas are sporadic, 5–10 % may have an underlying hereditary basis. Family history is central to identifying individuals who have an elevated risk of pancreatic cancer and for quantifying their risk. Familial pancreatic cancer is defined as kindred with at least two first-degree relatives with pancreatic cancer. Other genetic syndromes that are associated with an increased risk of pancreatic cancer include Peutz–Jeghers syndrome, familial atypical multiple mole melanoma, hereditary breast and ovarian cancer syndrome, Lynch syndrome, Li–Fraumeni syndrome, and hereditary pancreatitis.

Although population-based screening for early detection of pancreatic adenocarcinoma is of low yield given its low incidence in the general population, emerging data suggest that high-risk subgroups may benefit from surveillance with imaging, including magnetic resonance imaging and endoscopic ultrasound. While there is consensus regarding the importance of screening for pancreatic cancer in high-risk individuals, the frequency of surveillance and the management of early pancreatic lesions detected remain controversial. This chapter will review the epidemiology and genetic basis of hereditary pancreatic cancer and the current screening and management guidelines for individuals at high risk for pancreatic cancer.

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Authors and Affiliations

  1. Division of Gastroenterology, Brigham and Women’s Hospital, Boston, MA, USA

    Jennifer Nayor M.D., Shilpa Grover M.D., M.P.H. & Sapna Syngal M.D., M.P.H.

  2. Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA

    Jennifer Nayor M.D. & Sapna Syngal M.D., M.P.H.

  3. Harvard Medical School, Boston, MA, USA

    Jennifer Nayor M.D., Shilpa Grover M.D., M.P.H. & Sapna Syngal M.D., M.P.H.

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  1. Jennifer Nayor M.D.
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  2. Shilpa Grover M.D., M.P.H.
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Correspondence to Sapna Syngal M.D., M.P.H. .

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Editors and Affiliations

  1. Division of Gastroenterology, University of Florida, Gainesville, Florida, USA

    Mihir S. Wagh

  2. Division of Gastroenterology, University of Florida, Gainesville, Florida, USA

    Peter V. Draganov

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Nayor, J., Grover, S., Syngal, S. (2016). Evaluation and Surveillance Strategies for Patients at Increased Risk of Pancreatic Cancer. In: Wagh, M., Draganov, P. (eds) Pancreatic Masses. Springer, Cham. https://doi.org/10.1007/978-3-319-19677-0_15

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