GCSA is proud to introduce our pancreatic cancer screening program
South Texas Pancreatic Cancer Screening Service
Pancreatic cancer (PC) is the 3rd most lethal malignancy with an estimated 55,000 Americans diagnosed in 2018 and 44,000 will die from the disease.1 Surgery is the only real hope for cure, but because the disease presents late, only 15-20% of patients are candidates for pancreatectomy. It is estimated that 10% of pancreatic cancer develops as a result of a familial or an identifiable genetic predisposition. Request an Appointment Today!
South Texas Pancreatic Cancer Screening Test Service
While screening for PC in the general population is not cost-effective, targeting high-risk populations may result in a higher likelihood of detecting precursor lesions (e.g. cystic neoplasms) or early, stage I disease with higher rates of operability and improved outcomes. The relative risk (RR) of developing PC is markedly elevated in several patient populations.
Who should be considered for screening:2
- First degree relatives (FDRs) from a familial PC kindred with at least 2 affected family members, one of which is a FDR
- Peutz-Jeghers Syndrome, STK II mutation (RR=132)
- Hereditary pancreatitis, PRSSl, SPINKl, CTRC, CFTR mutation (RR 50-82)
- FAMMM syndrome, p16 gene mutation (RR 46)
- Li Fraumeni syndrome, TP53 mutation (RR 7)
- BRCAl mutation (RR 1.9-5.3)3
- BRCA2 mutation carriers (RR 3.5-22)
- Lynch II (HNPCC) mutation carriers, MLHl, MSH2, MSH6, PMS2 mutation (RR9)
- ATM mutation (RR 2.7)
- PALB2 mutation (RR unknown)
- Unexplained acute pancreatitis
How are patients screened?
- Endoscopic ultrasound, by highly experienced endosonographers, alternating annually with a contrast enhanced MRI beginning lOy prior to age of youngest affected FDR, or age 40, whichever is sooner. Interval adjusted based on abnormalities. MRI ineligible patients undergo annual EUS.
- Annual serum CEA and CA 19-9
- Genetic counselling services available
Who is not a candidate for routine screening?
- No family history of PC or only 1 FDR
1) American Cancer Society. Cancer Facts and Figures 2018.
2) Ml Canto et al, International Cancer of the Pancreas Screening (CAPS) Consortium Summit. Gut 2013;62-339-347
3) A Chhodaefal. Current Approach to Pancreatic Screening, AM J Pathology Jan, 2019.
Request an Appointment Today!