Early Detection of Pancreatic Cancer

Currently, it is not recommended for the general population to undergo pancreatic cancer screening. However, for individuals at increased risk, screening can be considered. Your family history will also be considered when deciding whether pancreatic cancer screening would be beneficial. However, there is currently no evidence that pancreatic cancer screening decreases pancreatic cancer-related death. There is also the possibility that non-cancerous cysts will be found and require frequent follow-up or surgery.

This list can help determine if you and your family may benefit from a formal clinic evaluation.

Risk Factors for Pancreatic Cancer:

• Pancreatic cysts: There are many types of benign pancreatic cysts and pseudocysts, as well as precancerous cysts, such as intraductal papillary mucinous neoplasm (IPMN) or mucinous cystic neoplasm (MCN). While most pancreatic cysts will not cause pancreatic cancer, it's important to be evaluated by a pancreatic expert to determine the cyst type and best treatment options.
• Patients above the age of 50 who have new-onset diabetes are at higher risk of having pancreatic cancer. Up to 85 percent of people with pancreatic cancer have diabetes or hyperglycemia, which frequently manifests as early as two to three years before the diagnosis of cancer is made. Patients with new-onset diabetes have an increased risk of being diagnosed with pancreatic cancer within one to three years of developing diabetes.
• Two relatives with pancreatic cancer, one of whom is a first-degree relative (parent, sibling, child)
• Two or more second-degree relatives (grandparent, aunt/uncle, niece/nephew, half-sibling) with pancreatic cancer, one of whom developed it at an early age
• Three or more relatives with pancreatic cancer
• History of a genetic syndrome associated with pancreatic cancer (see table below)

Genetic Syndromes Associated with Pancreatic Cancer

Up to 20 percent of pancreatic cancers have a genetic link, however, most patients — and many physicians — are not aware of the genetic factor of this disease. As a result, patients have died without the potential impact of the genetics being shared with their families. UChicago Medicine physician-scientists are studying the genes of cancer patients and their families with the goal of preventing cancer or finding cancer before it may become incurable.

At UChicago Medicine, we offer a customized approach to early detection of pancreatic cancer. Our team includes experts in gastrointestinal interventional endoscopy, pancreatic surgery, genetics, radiology and pathology. Together, these specialists create screening and treatment plans tailored to each patient's needs, and can recommend screening measures for family members who may also be at risk.

Before the first clinic appointment, each patient speaks with a genetic counselor to discuss prior health concerns, family medical history and previous diagnostic tests. In most cases, patients will meet with both a physician and genetic counselor to interpret the family history and determine the best work-up for the patient. If appropriate, the patient may be offered genetic testing and/or pancreatic cancer screening through imaging tests and/or endoscopic procedures.

If a predisposition to cancer is present, our physicians may recommend one, or a combination of, imaging tests.

Not all tests and services are appropriate for everyone. Depending upon your risk factors and medical history, our physicians may recommend follow-up testing at predetermined intervals.

The quality of abdominal imaging has significantly improved, allowing for better detection of small pancreatic cysts (lesions). Some people who have suspicious lesions may need surgery, because they may be precursors to pancreatic adenocarcinoma. Others may benefit from yearly follow-up appointments. The recommended care plan is determined by symptoms and the type, location and size of the lesion (e.g. intraductal papillary mucinous neoplasm or mucinous cystic neoplasm).

If surgery is necessary, a general surgeon who specializes in pancreatic surgery will remove the lesions. Our general surgeons are highly experienced at performing the full range of pancreatic surgeries, from minimally invasive procedures to complex surgeries such as the Whipple procedure for treatment of pancreatic cancer.

If you are susceptible to pancreatic cancer due to the hereditary or genetic factors outlined above, please talk with your doctor or contact us for a comprehensive consultation. We'll review your risk factors with you and develop a customized screening plan. For more information and to make an appointment, call 1-855-702-8222.