Familial Pancreatic Cancer: To Screen or not to Screen?

Detlef Bartsch,Hans F.A Vasen

doi:10.1016/j.ebiom.2015.12.014

Abstract

Familial Pancreatic Cancer: To Screen or not to Screen?

Highlights

The prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) has not meaningfully improved over the recent decades and it is clear that the only way to improve matters will be through detection of early stage PDAC, or even better its precursor lesions (IPMN or PanIN3)
In the sensitivity analysis they evaluated additional screening strategies, screening intervals and surgical mortality. They found that one-time screening of the primary BRCA2 cohort at age 50 resulted in small life expectancy (LE) gains
Annual screening from age 50 was most effective for BRCA2 mutation carriers with two firstdegree relative (FDR) with PDAC (LE gain of 20 days), and for those with three or more FDR with PDAC (260 days) but not for the primary cohort

Summary

Introduction

The prognosis of patients with PDAC has not meaningfully improved over the recent decades and it is clear that the only way to improve matters will be through detection of early stage PDAC, or even better its precursor lesions (IPMN or PanIN3). A major problem that must be confronted when screening individuals at high-risk of PDAC is the potential morbidity (up to 40%) (Keck et al, 2015; Diener et al, 2011) and mortality (0.5–6%) associated with the surgical treatment of suspicious lesions (Keck et al, 2015; Diener et al, 2011), even in specialized centers. In the absence of long-term clinical studies, the study by Pandharipande and colleagues provides important information on the effectiveness of screening in relation to the risk of developing PDAC in BRCA2 mutation carriers (Pandharipande et al, 2015).

Objectives

Results

Conclusion