Five years of prospective screening of high-risk individuals from families with familial pancreatic cancer
- P Langer 1, P H Kann , V Fendrich , N Habbe , M Schneider , M Sina , E P Slater , J T Heverhagen , T M Gress , M Rothmund , D K Bartsch
- P Langer 1, P H Kann , V Fendrich
- 1Department of General Surgery, Philipps-University Marburg, Germany. langerp@med.uni-marburg.de
- 0Department of General Surgery, Philipps-University Marburg, Germany. langerp@med.uni-marburg.de
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View abstract on PubMed
Summary
This summary is machine-generated.Screening high-risk individuals (HRIs) for familial pancreatic cancer (FPC) using endoscopic ultrasound and MRI detected precursor lesions but had a low diagnostic yield. The significant psychological stress and costs do not justify general screening for FPC in HRIs.
Area Of Science
- Oncology
- Gastroenterology
- Medical Imaging
Background
- Familial pancreatic cancer (FPC) constitutes a small but significant portion of all pancreatic cancer (PC) cases.
- High-risk individuals (HRIs) within FPC families are candidates for targeted screening programs.
- Previous studies suggest the potential benefit of screening programs for early detection.
Purpose Of The Study
- To assess the diagnostic yield of a prospective screening program for HRIs in FPC families over a five-year period.
- To evaluate the effectiveness of combined endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) in detecting pancreatic abnormalities.
Main Methods
- HRIs from FPC families were enrolled in a prospective screening program.
- Screening protocols included clinical examinations, laboratory tests, EUS, and MRI with MRCP and MR angiography.
- Abnormal findings led to fine needle aspiration cytology and, in some cases, operative pancreatic exploration.
Main Results
- Over five years, 76 HRIs underwent 182 screening visits.
- Twenty-eight patients showed abnormalities on EUS and/or MRI/MRCP.
- Six individuals underwent limited resections revealing precursor lesions like serous oligocystic adenomas and various grades of PanIN and IPMN.
Conclusions
- EUS/MR/MRCP-based screening can detect potential precursor lesions of PC in FPC families.
- The overall diagnostic yield of this extensive screening program was low.
- The substantial psychological burden and high costs associated with screening do not currently justify its general implementation in HRIs.
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