Abstract

Enrolling patients in studies of pancreatic ductal adenocarcinoma (pdac) is challenging because of the high fatality of the disease. We hypothesized that a prospective clinic-based study with rapid ascertainment would result in high participation rates. Using that strategy, we established the Quebec Pancreas Cancer Study (qpcs) to investigate the genetics and causes of pdac and other periampullary tumours (pats) that are also rare and underrepresented in research studies. Patients diagnosed with pdac or pat were introduced to the study at their initial clinical encounter, with a strategy to enrol participants within 2 weeks of diagnosis. Patient self-referrals and referrals of unaffected individuals with an increased risk of pdac were also accepted. Family histories, epidemiologic and clinical data, and biospecimens were collected. Additional relatives were enrolled in families at increased genetic risk. The first 346 completed referrals led to 306 probands being enrolled, including 190 probands affected with pdac, who represent the population focus of the qpcs. Participation rates were 88.4% for all referrals and 89.2% for pdac referrals. Family history, epidemiologic and clinical data, and biospecimens were ascertained from 91.9%, 54.6%, and 97.5% respectively of patients with pdac. Although demographics and trends in risk factors in our patients were consistent with published statistics for patients with pdac, the qpcs is enriched for families with French-Canadian ancestry (37.4%), a population with recurrent germ-line mutations in hereditary diseases. Using rapid ascertainment, a pdac and pat research registry with high participation rates can be established. The qpcs is a valuable research resource and its enrichment with patients of French-Canadian ancestry provides a unique opportunity for studies of heredity in these diseases.

Highlights

  • Pancreatic ductal adenocarcinoma is a lethal malignancy with a 5-year survival rate of only 6%1–3

  • Demographics and trends in risk factors in our patients were consistent with published statistics for patients with pdac, the qpcs is enriched for families with French-Canadian ancestry (37.4%), a population with recurrent germline mutations in hereditary diseases

  • A resource of that calibre had not been established in Quebec, and the Ontario Pancreas Cancer Study was the only reported Canadian pdac research registry[7]

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Summary

Introduction

Pancreatic ductal adenocarcinoma (pdac) is a lethal malignancy with a 5-year survival rate of only 6%1–3 It represents the 4th leading cause of cancer-related death in Quebec, with an estimated 1290 new cases diagnosed and 1170 deaths in 20141. The therapeutic options currently available for such patients are largely ineffective, and even patients who present with operable disease have poor outcomes because of early distant and local recurrence[5] Despite those tragic statistics, pdac has, compared with other major cancers, been underrepresented in research studies largely because of its rapid progression and fatality—median survival being less than 4 months in the presence of metastatic disease[3]. High-quality epidemiologic data and biospecimens for pdac research studies have been lacking To overcome those challenges, several prospective pdac research registries have been established in Europe and North America[6]. We established the Quebec Pancreas Cancer Study (qpcs) to investigate the genetics and causes of pdac and other periampullary tumours (pats) that are rare and underrepresented in research studies

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