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Management of patients with increased risk for familial pancreatic cancer: updated recommendations from the International Cancer of the Pancreas Screening (CAPS) Consortium
- Source :
- Gut, 69(1), 7-17. BMJ Publishing Group, Gut, Gut. BMJ Publishing Group
- Publication Year :
- 2020
- Publisher :
- BMJ Publishing Group, 2020.
-
Abstract
- Background and aimThe International Cancer of the Pancreas Screening Consortium met in 2018 to update its consensus recommendations for the management of individuals with increased risk of pancreatic cancer based on family history or germline mutation status (high-risk individuals).MethodsA modified Delphi approach was employed to reach consensus among a multidisciplinary group of experts who voted on consensus statements. Consensus was considered reached if ≥75% agreed or disagreed.ResultsConsensus was reached on 55 statements. The main goals of surveillance (to identify high-grade dysplastic precursor lesions and T1N0M0 pancreatic cancer) remained unchanged. Experts agreed that for those with familial risk, surveillance should start no earlier than age 50 or 10 years earlier than the youngest relative with pancreatic cancer, but were split on whether to start at age 50 or 55. Germline ATM mutation carriers with one affected first-degree relative are now considered eligible for surveillance. Experts agreed that preferred surveillance tests are endoscopic ultrasound and MRI/magnetic retrograde cholangiopancreatography, but no consensus was reached on how to alternate these modalities. Annual surveillance is recommended in the absence of concerning lesions. Main areas of disagreement included if and how surveillance should be performed for hereditary pancreatitis, and the management of indeterminate lesions.ConclusionsPancreatic surveillance is recommended for selected high-risk individuals to detect early pancreatic cancer and its high-grade precursors, but should be performed in a research setting by multidisciplinary teams in centres with appropriate expertise. Until more evidence supporting these recommendations is available, the benefits, risks and costs of surveillance of pancreatic surveillance need additional evaluation.
- Subjects :
- Endoscopic ultrasound
medicine.medical_specialty
Biomedical Research
MEDLINE
pancreatic ductal adenocarcinoma
familial pancreatic cancer
Biomedical Research/methods
Article
Germline mutation
Mass Screening/methods
SDG 3 - Good Health and Well-being
Risk Factors
Pancreatic cancer
medicine
Humans
Mass Screening
Pancreatic Neoplasms/diagnosis
Age Factor
Genetic Predisposition to Disease
Family history
Intensive care medicine
early detection
Early Detection of Cancer
Germ-Line Mutation
Medicine(all)
Hereditary pancreatitis
medicine.diagnostic_test
business.industry
Carcinoma
Age Factors
Gastroenterology
Pancreatic Neoplasm
Cancer
medicine.disease
Carcinoma/diagnosis
Population Surveillance/methods
Pancreatic Neoplasms
medicine.anatomical_structure
Population Surveillance
surveillance
Early Detection of Cancer/methods
business
Pancreas
genetic predisposition
Human
Subjects
Details
- Language :
- English
- ISSN :
- 00175749
- Database :
- OpenAIRE
- Journal :
- Gut, 69(1), 7-17. BMJ Publishing Group, Gut, Gut. BMJ Publishing Group
- Accession number :
- edsair.doi.dedup.....a2c9410df31cfebb192bda730d7282ef