Screening for pancreatic cancer
This section covers the following topics:
- Types of pancreatic cancer screening
- Pancreatic cancer screening guidelines for high risk people
Experts do not recommend screening healthy people at average risk for pancreatic cancer. In people at high for pancreatic cancer, screening is only recommended for certain people.
- Contrast-enhanced magnetic resonance cholangiopancreatography (MRCP) is a special type of imaging that looks closely at the pancreas, liver, gallbladder, bile duct and pancreatic duct to find abnormalities such as cancer. People undergoing MRCP must fast for four hours before the procedure. An injection of contrast agent—called gadolinium—is given before the test in order to help radiologists to find abnormalities more easily.
- Endoscopic (EUS) involves passing a tiny scope with an attached probe down the esophagus to the stomach. This allows doctors to look closely at the pancreas. EUS is performed as an outpatient procedure under anesthesia.
Endoscopic procedure to look for pancreatic tumors
National Comprehensive Cancer Network (NCCN) Guidelines
NCCN recommends that people undergoing pancreatic screening have the procedure at a facility with experience screening people at high risk for pancreatic cancer. Before undergoing screening, people should have a conversation with their doctor about the potential benefits, risks, costs and limitations of screening.
NCCN recommends that people with inherited mutations in the following genes (with or without a family history of cancer) "consider pancreatic cancer screening" with MRCP or EUS:
- : (): Consider pancreatic cancer screening by MRCP or EUS every 1-2 years beginning at age 30-35 or 10 years younger than the earliest pancreatic cancer in the family.
- CDKN2A: Consider pancreatic cancer screening beginning at age 40 or 10 years earlier than the earliest pancreatic cancer diagnosis in the family.
NCCN guidelines recommend that people with an in one of the following genes and a family history of pancreatic cancer "consider pancreatic cancer screening" with MRCP or EUS beginning at age 50 or 10 years earlier than the earliest pancreatic cancer diagnosis in the family:
American Society for Gastrointestinal Endoscopy (ASGE) Guidelines
The ASGE released new guidelines on pancreatic cancer screening for people with a and mutation. These guidelines are different from NCCN guidelines for people with and mutations. ASGE recommends:
- All people with a or mutation regardless of family history of pancreatic cancer, should undergo annual screening for pancreatic cancer with MRI/MRCP or EUS beginning at age 50 (or 10 years earlier than the earliest pancreatic cancer in the family).
If you have an that increases your risk for pancreatic cancer, talk with your healthcare team to decide if pancreatic cancer screening is right for you.
The organization, Collaborative Group of the Americas- Inherited Gastrointestinal Cancer (CGA-IGC) curates an updated list of hospitals and programs with expertise in pancreatic cancer screening for high-risk people.
The following are studies looking at risk management for pancreatic cancer:
- NCT03250078: A Pancreatic Cancer Screening Study in Hereditary High-Risk Individuals. The main goal of this study is to screen and detect pancreatic cancer and precursor lesions in individuals with a strong family history or genetic predisposition to pancreatic cancer. Magnetic Resonance Imaging and Magnetic cholangiopancreatography (MRI/MRCP) will be utilized to screen for pancreatic cancer or precursor lesions.
- NCT02478892: Preliminary Evaluation of Screening for Pancreatic Cancer in Patients With Inherited Genetic Risk. The study is a , observational study evaluating the utility of endoscopic or for the identification of preneoplastic and neoplastic pancreatic lesions in patients at high risk for pancreatic cancer, specifically those with BRCA1/2, or mutations.
- NCT03568630: Blood Markers of Early Pancreas Cancer. Identifying biomarkers of early pancreatic ductal () could facilitate screening for individuals at higher-than-average risk, expedite the diagnosis in individuals with symptoms and substantially improve an individual's chance of surviving the disease.
- NCT02206360: Pancreatic Cancer Early Detection Program (PCEDP). This is a study looking at esophageal as a screening for pancreatic cancer in high risk individuals.
- NCT03250078: A Pancreatic Cancer Screening Study in Hereditary High Risk Individuals. The goal is to screen for pancreatic cancer in individuals with a strong family history or genetic risk using Magnetic Resonance Imaging and Magnetic cholangiopancreatography (MRI/MRCP).
A number of other clinical trials for pancreatic cancer screening and prevention may be found here.