Tags

Type your tag names separated by a space and hit enter

Pancreatic cancer screening in high-risk individuals with germline genetic mutations.
Gastrointest Endosc 2018; 87(6):1443-1450GE

Abstract

BACKGROUND AND AIMS

Pancreatic cancer (PC) is a deadly disease that is most commonly diagnosed at an incurable stage. Different high-risk genetic variants and cancer syndromes increase the lifetime risk of developing PC. This study aims to assess the yield of initial PC screening in patients with high-risk germline mutations.

METHODS

Asymptomatic adults underwent PC screening by EUS, magnetic resonance imaging, or CT during a 10-year period and were retrospectively identified. High-risk individuals were defined as carrying germline mutations in BRCA1, BRCA2, p53 (Li-Fraumeni), STK11 (Peutz-Jeghers), MSH2 (Lynch), ATM (ataxia-telangiectasia), or APC (familial adenomatous polyposis). Patients without germline mutations were excluded.

RESULTS

In total, 86 patients met the study criteria. The median age was 48.5 years (interquartile range, 40-58), 79.1% (68) were women, and 43.0% (37) had a family history of PC. The genetic mutations were BRCA2 (50, 58.1%), BRCA1 (14, 16.3%), p53 (12, 14.0%), STK11 (5, 5.8%), MSH2 (3, 3.5%), ATM (1, 1.2%), and APC (1, 1.2%). Screening detected a pancreatic abnormality (PA) in 26.7% (23/86), including cysts (11, 47.8%), hyperechoic strands and foci (10, 43.5%), and mild pancreatic duct dilation (2, 8.7%). Patients older than 60 years were more likely to have a PA detected (P = .043). EUS detected more PAs than magnetic resonance imaging or CT. No cases of PC were diagnosed by screening or during follow-up (median, 29.8 months; interquartile range, 21.7-43.5).

CONCLUSIONS

Unless indicated otherwise by family or personal history, PC screening under the age of 50 is low yield. Linear EUS may be the preferred modality for initial PC screening.

Authors+Show Affiliations

Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29309780

Citation

DaVee, Tomas, et al. "Pancreatic Cancer Screening in High-risk Individuals With Germline Genetic Mutations." Gastrointestinal Endoscopy, vol. 87, no. 6, 2018, pp. 1443-1450.
DaVee T, Coronel E, Papafragkakis C, et al. Pancreatic cancer screening in high-risk individuals with germline genetic mutations. Gastrointest Endosc. 2018;87(6):1443-1450.
DaVee, T., Coronel, E., Papafragkakis, C., Thaiudom, S., Lanke, G., Chakinala, R. C., ... Lee, J. H. (2018). Pancreatic cancer screening in high-risk individuals with germline genetic mutations. Gastrointestinal Endoscopy, 87(6), pp. 1443-1450. doi:10.1016/j.gie.2017.12.019.
DaVee T, et al. Pancreatic Cancer Screening in High-risk Individuals With Germline Genetic Mutations. Gastrointest Endosc. 2018;87(6):1443-1450. PubMed PMID: 29309780.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pancreatic cancer screening in high-risk individuals with germline genetic mutations. AU - DaVee,Tomas, AU - Coronel,Emmanuel, AU - Papafragkakis,Charilaos, AU - Thaiudom,Sayam, AU - Lanke,Gandhi, AU - Chakinala,Raja C, AU - Nogueras González,Graciela M, AU - Bhutani,Manoop S, AU - Ross,William A, AU - Weston,Brian R, AU - Lee,Jeffrey H, Y1 - 2018/01/05/ PY - 2017/07/11/received PY - 2017/12/03/accepted PY - 2018/1/9/pubmed PY - 2018/11/9/medline PY - 2018/1/9/entrez SP - 1443 EP - 1450 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 87 IS - 6 N2 - BACKGROUND AND AIMS: Pancreatic cancer (PC) is a deadly disease that is most commonly diagnosed at an incurable stage. Different high-risk genetic variants and cancer syndromes increase the lifetime risk of developing PC. This study aims to assess the yield of initial PC screening in patients with high-risk germline mutations. METHODS: Asymptomatic adults underwent PC screening by EUS, magnetic resonance imaging, or CT during a 10-year period and were retrospectively identified. High-risk individuals were defined as carrying germline mutations in BRCA1, BRCA2, p53 (Li-Fraumeni), STK11 (Peutz-Jeghers), MSH2 (Lynch), ATM (ataxia-telangiectasia), or APC (familial adenomatous polyposis). Patients without germline mutations were excluded. RESULTS: In total, 86 patients met the study criteria. The median age was 48.5 years (interquartile range, 40-58), 79.1% (68) were women, and 43.0% (37) had a family history of PC. The genetic mutations were BRCA2 (50, 58.1%), BRCA1 (14, 16.3%), p53 (12, 14.0%), STK11 (5, 5.8%), MSH2 (3, 3.5%), ATM (1, 1.2%), and APC (1, 1.2%). Screening detected a pancreatic abnormality (PA) in 26.7% (23/86), including cysts (11, 47.8%), hyperechoic strands and foci (10, 43.5%), and mild pancreatic duct dilation (2, 8.7%). Patients older than 60 years were more likely to have a PA detected (P = .043). EUS detected more PAs than magnetic resonance imaging or CT. No cases of PC were diagnosed by screening or during follow-up (median, 29.8 months; interquartile range, 21.7-43.5). CONCLUSIONS: Unless indicated otherwise by family or personal history, PC screening under the age of 50 is low yield. Linear EUS may be the preferred modality for initial PC screening. SN - 1097-6779 UR - https://www.unboundmedicine.com/medline/citation/29309780/Pancreatic_cancer_screening_in_high_risk_individuals_with_germline_genetic_mutations_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(18)30005-1 DB - PRIME DP - Unbound Medicine ER -