Screening for pancreatic neoplasia in high-risk individuals: an EUS-based approach
Abstract
Background & aims Relatives of patients with pancreatic cancer and persons with certain inherited syndromes are at increased risk for developing pancreatic cancer. We prospectively evaluated the feasibility of screening for pancreatic neoplasia in high-risk individuals.Methods Individuals from familial pancreatic cancer kindreds and a patient with Peutz-Jeghers syndrome underwent screening endoscopic ultrasound (EUS). If the EUS was abnormal, EUS-guided fine-needle aspiration, endoscopic retrograde cholangiopancreatography (ERCP), and spiral computed tomography (CT) were performed. Patients with abnormalities suggesting neoplasia had surgery.Results Thirty-eight patients were studied; 31 (mean age, 58 yr; 42% men) from kindreds with > or =3 affected with pancreatic cancer; 6 from kindreds with 2 affected relatives, 1 was a patient with Peutz-Jeghers syndrome. None had symptoms referable to the pancreas or suggestive of malignancy. Six pancreatic masses were found by EUS: 1 invasive ductal adenocarcinoma, 1 benign intraductal papillary mucinous neoplasm, 2 serous cystadenomas, and 2 nonneoplastic masses. Hence, the diagnostic yield for detecting clinically significant pancreatic neoplasms was 5.3% (2 of 38). The 1 patient with pancreatic cancer was treated and still is alive and disease-free >5 years after surgery. EUS changes similar to those associated with chronic pancreatitis were found, which were more common in patients with a history of regular alcohol intake (P = 0.02), but also occurred in patients who did not consume alcohol. Screening also led to a new diagnosis and treatment of symptomatic upper-gastrointestinal conditions in 18.4% of patients.Conclusions EUS-based screening of asymptomatic high-risk individuals can detect prevalent resectable pancreatic neoplasia but false-positive diagnoses also occur.
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Medical imaging has been shown to detect precancerous tissue changes in the pancreas among individuals at high risk.
“The ability to detect precancerous tissue changes in the pancreas using medical imaging among individuals at high risk has also been shown.110,122–125”
From Early detection of pancreatic cancer (2020) · cites this paper as [122]
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Self-citationEarly Diagnosis of Pancreatic Cancer: The Key for Survival
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Self-citationThe role of endoscopic ultrasound in pancreatic cancer screening
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Surveillance for neoplasia in the pancreas
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Self-citation
- Authors
- Canto, M. I., Goggins, M., Yeo, C. J., Griffin, C., Axilbund, J. E., Brune, K., Ali, S. Z., Jagannath, S., Petersen, G. M., Fishman, E. K., Piantadosi, S., Giardiello, F. M., & Hruban, R. H.
- Affiliations
- Johns Hopkins University (US)
- Mayo Clinic (US)
- Corresponding author
- Canto, Marcia Irene
- ORCID
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2004-07
- Volume
- 2
- Issue
- 7
- Pages
- 606-621
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W1994015078
- Cited by
- 448
- References
- 69
- Citations by year
- 2026: 4 · 2024: 13 · 2023: 13 · 2022: 12 · 2021: 8 · 2020: 14 · 2019: 18 · 2018: 20 · 2017: 19 · 2016: 22 · 2015: 29 · 2014: 19 · 2013: 20 · 2012: 37
- FWCI
- 12.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (2 P50 CA62924, P50CA062924)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Gallbladder and Bile Duct Disorders
- Keywords
- pancreatic cancer screening, endoscopic ultrasound, familial pancreatic cancer, Peutz-Jeghers syndrome, hereditary cancer, pancreatic neoplasms, endoscopic ultrasound-guided fine-needle aspiration, intraductal papillary mucinous neoplasm, serous cystadenoma, chronic pancreatitis, alcohol consumption, false positives, upper gastrointestinal diseases
- MeSH terms
- Aged, Biopsy, Needle, Cholangiopancreatography, Endoscopic Retrograde, Feasibility Studies, Female, Humans, Immunohistochemistry, Male, Mass Screening, Middle Aged, Pancreatic Neoplasms, Patient Compliance, Pedigree, Probability, Prognosis, Prospective Studies, Tomography, X-Ray Computed, Program Evaluation, Prevalence, Age Distribution, Sex Distribution, Risk Assessment, Statistics, Nonparametric, Endosonography, Genetic Predisposition to Disease
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