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Hereditary Cancer Info > Risk Management > Risk Management Guidelines

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Risk Management Guidelines

Learn about the steps that people at high risk for cancer can take to manage their risk and protect their health.

Guidelines for men and women with Peutz-Jeghers syndrome (STK11 mutations)

Breast and ovarian cancer screening for women

  • Clinical breast exam every 6 months beginning at age 25
  • Annual breast MRI and mammogram beginning at age 25
  • Annual pelvic exam and PAP smear beginning at age 18-20
  • Consider transvaginal ultrasound beginning at age 18-20

Cancer screnning for men 

  • Annual testicular exam 

Guidelines for men and women 

  • Colonoscopy every 2-3 years beginning in late teens
  • Upper endoscopy every 2-3 years beginning in late teens
  • Small bowel CT, MRI or video capsule endoscopy starting at age 8-10 with a followup by age 18, and then every 2-3 years
  • Magnetic resonance cholangiopancreatography with contrast or endoscopic ultrasound every 1-2 years beginning age 30-35

Pancreatic cancer

People with a mutation in STK11 are encouraged to discuss the pros and cons of annual screening with their health care provider.  Pancreatic cancer screening is done using two types of medical procedures: 

  • Magnetic resonance cholangiopancreatography (MRCP) is a special type of imaging MRI that is used to look at the pancreas, liver, gallbladder, bile duct and pancreatic duct. 
  • Endoscopic ultrasound (EUS) involves passing a tiny scope with an attached ultrasound probe down the esophagus to the stomach. This allows doctors to look closely at the pancreas.

Experts recommend the following:

  • Consider beginning pancreatic cancer screening beginning at age 30-35 years (or 10 years earlier than the earliest pancreatic cancer diagnosis in the family, whichever is earlier).
  • Screening should begin with annual MRCP and/or EUS (both ideally performed at a center with expertise).

People with a STK11 mutation may also be eligible for pancreatic cancer screening clinical trials. Visit our research study page for links to clinical trials for early detection of pancreatic cancer.

Reproductive options

  • For patients of reproductive age, advise about options for prenatal diagnosis and assisted reproduction including pre-implantation genetic diagnosis. 

Risk to relatives

  • Advise about possible inherited cancer risk to relatives, options for risk assessment, and management. 
  • Recommend genetic counseling and consideration of genetic testing for at-risk relatives. 


Updated 02/03/2020

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