Tests Detect Pancreatic Cancer Risk

People who are at high risk of pancreatic cancer because of a family history of the disease can benefit from a combination of tests that determine if they too are developing the disease, results of a new study suggest.

Pancreatic cancer is the fourth leading cause of cancer death in the US and is often so advanced when discovered that most patients survive less than a year after diagnosis. About 10% of cases are linked to a family predisposition to the disease.

However, extensive screening can help determine if a person at high risk has precancerous lesions in the pancreas. In a new study, Dr. Teresa A. Brentnall and colleagues at the University of Washington in Seattle looked at 14 people from three different families that had a strong family history of the disease — at least two members in two generations had died of pancreatic cancer.

Seven subjects — including six people from the same family — had abnormal findings on two tests, endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography. These tests give doctors an opportunity to view the pancreas, and sample tissues.

The seven patients then had a pancreatectomy, or removal of the pancreas, which confirmed that they had pancreatic dysplasia, a precancerous condition.

All fourteen patients in the study remained under surveillance, and none has developed pancreatic cancer during follow-up ranging from 1 to 4 years.

The average time between the development of pancreatic dysplasia and pancreatic cancer is 6 years, according to the report in the August 17th issue of the Annals of Internal Medicine. However, removing the pancreas is a serious undertaking, resulting in diabetes, and a risk of potentially life-threatening surgical complications.

Three of the four patients in the study who underwent genetic testing were found to be carriers of a specific gene mutation, according to the report. However, not all gene carriers will develop pancreatic cancer, the authors note.

The new findings suggest that one option is to begin screening for abnormalities in the pancreas “5 to 10 years before the earliest age at which pancreatic cancer was diagnosed within the family,” Brentnall and colleagues write.

Given the dismal prognosis for pancreatic cancer, there is a need to develop ways to find precancerous lesions in high-risk patients. For such people, the benefits of removing the pancreas would outweigh the risks of the surgery, the authors conclude.

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