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Am J Pathol. 2019 Jan;189(1):22-35. doi: 10.1016/j.ajpath.2018.09.013.

Current Approaches to Pancreatic Cancer Screening.

Author information

1
Yale Waterbury Internal Medicine Program, Yale School of Medicine, New Haven, Connecticut.
2
Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.
3
Pancreatic Disease Program, Yale School of Medicine, New Haven, Connecticut.
4
Yale Center for Pancreatic Diseases, Yale School of Medicine, New Haven, Connecticut; Yale Center for Pancreatic Diseases, Department of Digestive Diseases, Yale School of Public Health, New Haven, Connecticut. Electronic address: james.j.farrell@yale.edu.

Abstract

Pancreatic ductal adenocarcinoma (PDAC) has a 5-year survival rate of only 8% and is estimated to be the second leading cause of cancer-related deaths by 2021. Prior convention held that screening for PDAC would not be beneficial; however, a deeper understanding of the carcinogenesis pathway supports a potential window of opportunity among the target population. Screening for PDAC is not a standard practice among the general population because of its low incidence. However, screening may be beneficial for individuals with familial history, chronic diseases with genetic predispositions, or inherited cancer syndromes, such as hereditary breast ovarian cancer syndrome, hereditary pancreatitis, Peutz-Jeghers syndrome, familial atypical multiple mole melanoma, Lynch syndrome (hereditary nonpolyposis colorectal cancer), ataxia telangiectasia, and Li-Fraumeni syndrome, all of which have been associated with an increased risk of developing PDAC. The screening strategies among these high-risk individuals are targeted to identify precursor lesions and PDAC at an early resectable stage. This review describes the risk factors for pancreatic cancer, especially the genetic risk factors in high-risk individuals and current screening strategies available for PDAC.

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