Cited by 648Pancreatic and Hepatic Oncology ResearchPancreatitis Pathology and TreatmentGlobal Cancer Incidence and Screening

The DOI matches its Crossref record; 37 of the 38 references it cites were found in a registry or an index.

Frequent Detection of Pancreatic Lesions in Asymptomatic High-Risk Individuals

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Abstract

Background & aims The risk of pancreatic cancer is increased in patients with a strong family history of pancreatic cancer or a predisposing germline mutation. Screening can detect curable, noninvasive pancreatic neoplasms, but the optimal imaging approach is not known. We determined the baseline prevalence and characteristics of pancreatic abnormalities using 3 imaging tests to screen asymptomatic, high-risk individuals (HRIs).Methods We screened 225 asymptomatic adult HRIs at 5 academic US medical centers once, using computed tomography (CT), magnetic resonance imaging (MRI), and endoscopic ultrasonography (EUS). We compared results in a blinded, independent fashion.Results Ninety-two of 216 HRIs (42%) were found to have at least 1 pancreatic mass (84 cystic, 3 solid) or a dilated pancreatic duct (n = 5) by any of the imaging modalities. Fifty-one of the 84 HRIs with a cyst (60.7%) had multiple lesions, typically small (mean, 0.55 cm; range, 2-39 mm), in multiple locations. The prevalence of pancreatic lesions increased with age; they were detected in 14% of subjects younger than 50 years old, 34% of subjects 50-59 years old, and 53% of subjects 60-69 years old (P < .0001). CT, MRI, and EUS detected a pancreatic abnormality in 11%, 33.3%, and 42.6% of the HRIs, respectively. Among these abnormalities, proven or suspected neoplasms were identified in 85 HRIs (82 intraductal papillary mucinous neoplasms and 3 pancreatic endocrine tumors). Three of 5 HRIs who underwent pancreatic resection had high-grade dysplasia in less than 3 cm intraductal papillary mucinous neoplasms and in multiple intraepithelial neoplasias.Conclusions Screening of asymptomatic HRIs frequently detects small pancreatic cysts, including curable, noninvasive high-grade neoplasms. EUS and MRI detect pancreatic lesions better than CT.

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  1. Slater, 2010, PALB2 mutations in European familial pancreatic cancer families, Clin Genet, 78, 490, 10.1111/j.1399-0004.2010.01425.x · DOI · Paper page
  2. Canto, 2004, Screening for pancreatic neoplasia in high-risk individuals: an EUS-based approach, Clin Gastroenterol Hepatol, 2, 606, 10.1016/S1542-3565(04)00244-7 · DOI · Paper page
  3. Poley, 2009, The yield of first-time endoscopic ultrasonography in screening individuals at a high risk of developing pancreatic cancer, Am J Gastroenterol, 104, 2175, 10.1038/ajg.2009.276 · DOI · Paper page
  4. Vasen, 2011, Magnetic resonance imaging surveillance detects early-stage pancreatic cancer in carriers of a p16-Leiden mutation, Gastroenterology, 140, 850, 10.1053/j.gastro.2010.11.048 · DOI · Paper page

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Metadata

Authors
Canto, M. I., Hruban, R. H., Fishman, E. K., Kamel, I. R., Schulick, R., Zhang, Z., Topazian, M., Takahashi, N., Fletcher, J., Petersen, G., Klein, A. P., Axilbund, J., Griffin, C., Syngal, S., Saltzman, J. R., Mortele, K. J., Lee, J., Tamm, E., Vikram, R., Bhosale, P., Margolis, D., Farrell, J., & Goggins, M.
Affiliations
  • Johns Hopkins University (US)
  • Mayo Clinic (US)
  • Brigham and Women's Hospital (US)
  • The University of Texas MD Anderson Cancer Center (US)
  • University of California, Los Angeles (US)
Corresponding author
Canto, Marcia Irene
Venue
Gastroenterology
Publisher
Elsevier BV
Published
2012-04
Volume
142
Issue
4
Pages
796-804
ISSN
0016-5085 (ISSN-L)
OpenAlex
W2055276888
Cited by
648
References
38
Citations by year
2026: 21 · 2025: 22 · 2024: 42 · 2023: 42 · 2022: 39 · 2021: 47 · 2020: 37 · 2019: 52 · 2018: 55 · 2017: 65 · 2016: 54 · 2015: 63 · 2014: 39 · 2013: 43 · 2012: 27
FWCI
27.36
Type
journal article
Language
en
Open access
Locations
  • Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Cancer Institute (P50 CA62924)
  • Lustgarten Foundation
  • Olympus
Topics
  • Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
  • Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
Keywords
pancreatic cancer screening, high-risk individuals, pancreatic cysts, intraductal papillary mucinous neoplasm, pancreatic neuroendocrine tumors, pancreatic duct dilatation, endoscopic ultrasound, magnetic resonance imaging, computed tomography, pancreatic neoplasms, familial pancreatic cancer, germline mutations, intraepithelial neoplasia, pancreatic resection
MeSH terms
Academic Medical Centers, Aged, Diagnostic Imaging, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pancreatic Cyst, Pancreatic Neoplasms, Pedigree, Predictive Value of Tests, Prognosis, Prospective Studies, Risk Factors, Tomography, X-Ray Computed, United States, Prevalence, Multivariate Analysis, Chi-Square Distribution, Logistic Models, Risk Assessment, Endosonography, Genetic Predisposition to Disease, Heredity, Asymptomatic Diseases

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