The yield of first-time endoscopic ultrasonography in screening individuals at a high risk of developing pancreatic cancer
Abstract
OBJECTIVES: Approximately 10-15% of all pancreatic cancers (PCs) may be hereditary in origin. We investigated the use of endoscopic ultrasonography (EUS) for the screening of individuals at high risk for developing PC. In this paper the results of first-time screening with EUS are presented. METHODS: Those eligible for screening in this study were first-degree family members of affected individuals from familial pancreatic cancer (FPC) families, mutation carriers of PC-prone hereditary syndromes, individuals with Peutz-Jeghers syndrome, and mutation carriers of other PC-prone hereditary syndromes with clustering (> or =2 cases per family) of PC. All individuals were asymptomatic and had not undergone EUS before. RESULTS: Forty-four individuals (M/F 18/26), aged 32-75 years underwent screening with EUS. Thirteen were from families with familial atypical multiple-mole melanoma (FAMMM), 21 with FPC, 3 individuals were diagnosed with hereditary pancreatitis, 2 were Peutz-Jeghers patients, 3 were BRCA1 and 2 were BRCA2 mutation carriers with familial clustering of PC, and 1 individual had a p53 mutation. Three (6.8%) patients had an asymptomatic mass lesion (12, 27, and 50 mm) in the body (n=2) or tail of the pancreas. All lesions were completely resected. Pathology showed moderately differentiated adenocarcinomas with N1 disease in the two patients with the largest lesions. EUS showed branch-type intraductal papillary mucinous neoplasia (IPMN) in seven individuals. CONCLUSIONS: Screening of individuals at a high risk for PC with EUS is feasible and safe. The incidence of clinically relevant findings at first screening is high with asymptomatic cancer in 7% and premalignant IPMN-like lesions in 16% in our series. Whether screening improves survival remains to be determined, as does the optimal screening interval with EUS.
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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 [124]
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- Authors
- Poley, J. W., Kluijt, I., Gouma, D. J., Harinck, F., Wagner, A., Aalfs, C., van Eijck, C. H. J., Cats, A., Kuipers, E. J., Nio, Y., Fockens, P., & Bruno, M. J.
- Affiliations
- Erasmus MC (NL)
- The Netherlands Cancer Institute (NL)
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Poley, J W
- Venue
- The American Journal of Gastroenterology
- Published
- 2009-06-02
- Volume
- 104
- Issue
- 9
- Pages
- 2175-2181
- ISSN
- 0002-9270 (ISSN-L)
- 1572-0241
- OpenAlex
- W2028828517
- Cited by
- 257
- References
- 38
- Citations by year
- 2026: 3 · 2024: 7 · 2023: 12 · 2022: 9 · 2021: 4 · 2020: 8 · 2019: 11 · 2018: 23 · 2017: 18 · 2016: 18 · 2015: 23 · 2014: 25 · 2013: 15 · 2012: 25
- FWCI
- 13.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Keywords
- pancreatic cancer screening, endoscopic ultrasound, hereditary pancreatic cancer, familial pancreatic cancer, Peutz-Jeghers syndrome, hereditary pancreatitis, BRCA1, BRCA2, TP53 mutation, intraductal papillary mucinous neoplasm, pancreatic ductal adenocarcinoma, premalignant pancreatic lesions, high-risk individuals
- MeSH terms
- Adult, Aged, Female, Humans, Male, Mass Screening, Middle Aged, Pancreatic Neoplasms, Endosonography, Genetic Predisposition to Disease
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