Some Support for Pancreatic Cancer Screening

From Reuters Health Information

By Amy Norton

NEW YORK (Reuters Health) Apr 20 - For people at high genetic risk of pancreatic adenocarcinoma, screening for the disease might be worthwhile -- particularly if they're older than 65, a new study suggests.

On the other hand, the researchers say, it might not be worthwhile -- and it's too soon to make widespread recommendations on screening high-risk families.

Only about three of every 100 patients with pancreatic cancer have the familial form.

But the findings in this group offer reason to be "cautiously hopeful" that there might be ways to detect the cancer earlier, said lead researcher Dr. Emmy Ludwig, of Memorial Sloan-Kettering Cancer Center in New York.

The study, reported in the American Journal of Gastroenterology online April 5, focused on families affected by familial pancreatic cancer. The researchers enrolled 309 relatives of people with pancreatic adenocarcinoma.

Some had at least one first-degree relative who developed pancreatic cancer before age 50. Others had family members who developed it at any age -- not just a parent, child or sibling but also a grandparent, grandchild, aunt or uncle, or a sibling's child.

Some participants had gene mutations linked to hereditary pancreatic cancer, plus a family history of the disease.

Over 7 years, 109 people in the study underwent screening at least once with magnetic resonance cholangiopancreaticogram followed by endoscopic ultrasound with fine needle aspiration if indicated.

Abnormal radiographic findings were present in 18 study participants (16.5%). Nine (8%) of the whole group had a "significant abnormality." Six later had surgery for an overall diagnostic yield of 8.3%.

Six of the nine patients with abnormal lesions were older than 65. Perhaps, the researchers say, this means screening after age 65 could prove most useful -- but that requires further study.

"No single group has definitively proven that routine screening is of benefit," Dr. Ludwig told Reuters Health in an email. "Our findings, we feel, add to the growing literature that suggests screening may be worthwhile. None of us has proven it."

She said that larger, long-term studies at multiple centers are needed to figure out how, when and how often to screen relatives from affected families -- and to see whether screening actually saves lives.

SOURCE: http://bit.ly/gyZ8WQ

Am J Gastroenterol 2011.