Surveillance for neoplasia in the pancreas

Overbeek, Kasper A.; Cahen, Djuna L.; Canto, Marcia Irene; Bruno, Marco J.

doi:10.1016/j.bpg.2016.10.013

Cited by 24 publications

(12 citation statements)

References 140 publications

(130 reference statements)

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“…Individuals with both a family history and a pathogenic germline variant may benefit most, as they have been found to be at the highest risk of pancreatic cancer in screening studies, compared with individuals with a family history by no identifiable mutation [144]. Several screening approaches have been taken, but most rely on endoscopic ultrasound (EUS) combined with magnetic resonance imaging or computed tomography (CT) scanning [145][146][147]. Preliminary results from EUS-based screening trials have demonstrated that asymptomatic precursor lesions and, rarely, early curable cancers can be detected, and SEER data hint that more early stage cancers are now being detected nationally [145][146][147][148][149].…”

Section: Screening In Familial Syndromesmentioning

confidence: 99%

The genetics of ductal adenocarcinoma of the pancreas in the year 2020: dramatic progress, but far to go

et al. 2020

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The publication of the "Pan-Cancer Atlas" by the Pan-Cancer Analysis of Whole Genomes Consortium, a partnership formed by The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC), provides a wonderful opportunity to reflect on where we stand in our understanding of the genetics of pancreatic cancer, as well as on the opportunities to translate this understanding to patient care. From germline variants that predispose to the development of pancreatic cancer, to somatic mutations that are therapeutically targetable, genetics is now providing hope, where there once was no hope, for those diagnosed with pancreatic cancer.

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Section: Screening In Familial Syndromesmentioning

confidence: 99%

The genetics of ductal adenocarcinoma of the pancreas in the year 2020: dramatic progress, but far to go

et al. 2020

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“…The goal is to detect stage one PDAC or, preferably, high-grade precursor lesions [2]. However, especially in small lesions, imaging techniques may not be able to distinguish malignancy and high-grade precursors from benign disease [3,4].…”

Section: Introductionmentioning

confidence: 99%

Patient-reported burden of intensified surveillance and surgery in high-risk individuals under pancreatic cancer surveillance

et al. 2020

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In high-risk individuals participating in a pancreatic cancer surveillance program, worrisome features warrant for intensified surveillance or, occasionally, surgery. Our objectives were to determine the patient-reported burden of intensified surveillance and/or surgery, and to assess post-operative quality of life and opinion of surgery. Participants in our pancreatic cancer surveillance program completed questionnaires including the Cancer Worry Scale (CWS) and the Hospital Anxiety and Depression Scale (HADS). For individuals who underwent intensified surveillance, questionnaires before, during, and ≥ 3 weeks after were analyzed. In addition, subjects who underwent intensified surveillance in the past 3 years or underwent surgery at any time, were invited for an interview, that included the Short-Form 12 (SF-12). A total of 31 high-risk individuals were studied. During the intensified surveillance period, median CWS scores were higher (14, IQR 7), as compared to before (12, IQR 9, P = 0.007) and after (11, IQR 7, P = 0.014), but eventually returned back to baseline (P = 0.823). Median HADS scores were low: 5 (IQR 6) for anxiety and 3 (IQR 5) for depression, and they were unaffected by the intensified surveillance period. Of the 10 operated patients, 1 (10%) developed diabetes and 7 (70%) pancreatic exocrine insufficiency. The interviews yielded median quality-of-life scores comparable to the general population. Also, after surgery, patients' attitudes towards surveillance were unchanged (5/10, 50%) or became more positive (4/10, 40%). Although patients were aware of the (sometimes benign) pathological outcome, when asked if surgery had been justified, only 20% (2/10) disagreed, and all would again have chosen to undergo surgery. In conclusion, in individuals at high risk for pancreatic cancer, intensified surveillance temporarily increased cancer worries, without affecting general anxiety or depression. Although pancreatic surgery led to substantial co-morbidity, quality of life was similar to the general population, and surgery did not negatively affect the attitude towards surveillance.

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“…Screening is not currently recommended for the general population (US Preventive Services Task Force gives a D recommendation) [7]. However, some have suggested that screening patients at high risk of developing pancreatic cancer is feasible, while acknowledging that data for cost-effectiveness and benefit are still required [8]. To date, the most suitable imaging technology for such screening is unclear [5].…”

mentioning

confidence: 99%