Pancreatic Cancer Screening
Thanks to advances in human genetics and improved diagnostic tools, physicians can now offer screening services to people who are at risk for developing pancreatic cancer. Screening is important for those at risk because pancreatic cancer often does not produce symptoms until it has reached an advanced stage, when the cancer is difficult to treat. If doctors can monitor people at risk and identify early signs of cancer, more lives will be saved through effective care when the cancer is at a "treatable" stage.
- Who should be screened for pancreatic cancer?
- What kind of pancreatic screening services are available?
- What happens if suspicious lesions are present or I have pancreatic dysplasia?
- What should I do if I suspect that I am at risk for pancreatic cancer? How can I make an appointment for pancreatic cancer screening?
Q. Who should be screened for pancreatic cancer?
A. Not everyone should be screened for pancreatic cancer. Screening makes sense for people who are at risk for the disease, typically because of hereditary factors or genetic syndromes that increase the likelihood of developing pancreatic cancer.
Factors that Increase an Individual's Risk for Pancreatic Cancer:
- Two or more first-degree relatives (parents, sibling, child) with pancreatic cancer
- One first-degree relative diagnosed with pancreatic cancer at an early age (under the age of 50)
- 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
- History of a cancer syndrome associated with pancreatic cancer (see table below)
Genetic Syndromes Associated with Pancreatic Cancer
| Genetic Syndrome | Genetic Mutation | Clinical Clues |
Hereditary pancreatitis |
PRSSI |
History of early pancreatitis (inflammation of the pancreas) of unknown cause |
Breast-ovarian cancer syndrome |
BRCA2 |
History of breast and/or ovarian cancer |
Hereditary nonpolyposis colorectal cancer syndrome |
Mismatch repair genes |
Personal or family history of early colorectal cancer |
Familial atypical multiple mole melanoma syndrome (FAMMM) |
CDK2NA/p16 |
Multiple melanomas with or without history of pancreatic malignancy |
Peutz-Jeghers syndrome |
STK11/LKB1 |
Benign polyps of the gastrointestinal tract with pigmented macules on the lips, inner lining of the cheeks, and hands/feet |
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Q. What kind of pancreatic screening services are available?
A. At the University of Chicago Hospitals, we have special expertise in pancreatic cancer screening. Our team includes physician-scientists who specialize in cancer genetics, gastrointestinal endoscopy, and pathology, as well as genetic counselors and laboratory technicians. Together, these experts customize screening plans for each patient's needs, and can recommend screening measures for family members who may also be at risk.
Pancreatic cancer screening can involve both genetic testing that looks for mutations that increase the risk for pancreatic cancer, as well as other tests that are designed to find early signs of disease. In addition to comprehensive genetic testing and counseling services, some of the tests we provide include the following:
- Endoscopic ultrasound (EUS), a minimally invasive imaging test that uses an endoscope (thin, flexible tube) to evaluate the pancreas for lesions or early cancers. If suspicious lesions are present, doctors can obtain tissue biopsies during the same procedure.
- Magnetic resonance cholangiopancreatography (MRCP), a type of magnetic resonance imaging (MRI) test that focuses on the pancreas and bile duct.
- Endoscopic retrograde cholangiopancreatography (ERCP), a test that combines the use of endoscopes and X-rays to visualize the pancreas and biliary tree. Biopsies can also be performed during ERCP.
- Computed tomography (CT) scans, another imaging test that can show some types of suspicious lesions. Here, our experts can offer high-resolution 64-slice CT imaging, which produces better, more detailed diagnostic images.
Not all tests and services are appropriate for everyone. Depending upon your risk factors and personal history, our physicians may recommend follow-up testing at predetermined intervals.
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Q. What happens if suspicious lesions are present or I have pancreatic dysplasia?
A. Some people who have suspicious lesions or who have pancreatic dysplasia, a precursor to pancreatic adenocarcinoma, may be recommended for prophylactic surgery to remove part or all of the pancreas to avoid the development of cancer. At the University of Chicago Hospitals, our general surgeons are experienced in performing prophylactic pancreatic surgery.
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Q. What should I do if I suspect that I am at risk for pancreatic cancer? How can I make an appointment for pancreatic cancer screening?
A. If you are at risk for pancreatic cancer due to hereditary or genetic factors outlined above, please discuss your risks with your doctor or contact us for a comprehensive consultation with a genetic counselor. We'll review your risk factors with you to develop a customized screening plan. For more information and to make an appointment, call (773) 702-4749.
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