Pancreatic Cancer Screening

Summary of Pancreatic Cancer Screening Recommendations (Updated: Dec 23, 2016) from emedicine/

Pancreatic Cancer Screening

Guidelines on pancreatic cancer screening have been issued by the following organizations:
U.S. Preventive Services Task Force (USPSTF)
American Academy of Family Physicians (AAFP)
International Cancer of the Pancreas Screening (CAPS) Consortium

The USPSTF found no evidence that screening for pancreatic cancer is effective in reducing mortality and recommends against routine screening in asymptomatic adults using abdominal palpation, ultrasonography, or serologic markers. [1] The AAFP guidelines concur with the USPSTF recommendation. [2]
The USPSTF did not review the effectiveness of screening individuals at high risk for pancreatic cancer.

In 2012, the International CAPS Consortium, a panel of 49 multidisciplinary experts, released consensus guidelines for pancreatic cancer screening. While also recommending against routine screening in the general population, the members recommended screening with endoscopic ultrasound (EUS) and/or magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) for the following high-risk groups [3] :

  • Individuals with two or more blood relatives, and at least one first-degree relative, with pancreatic cancer

  • Carriers of p16, PALB2, or BRCA2 mutations with a first-degree relative with pancreatic cancer

  • All individuals with Peutz-Jeghers syndrome

  • Individuals with Lynch syndrome and a first-degree relative with pancreatic cancer

    (In practice, however, many carriers of p16, PALB2, or BRCA2 mutations opt for screening even if they do not have a relative with the disease.)

    The panel agreed that to be considered successful, screening should detect and lead to treatment of T1N0M0 margin-negative pancreatic cancer and high-grade dysplastic precursor lesions (pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasm). However, the group did not reach consensus on the optimal management of detected lesions, the age to begin screening, or screening intervals.

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