NEW YORK (Reuters Health) – Patients at high risk for pancreatic cancer can be effectively screened with imaging studies and genetic testing, allowing curable neoplasm to be identified and resected, researchers report in Clinical Cancer Research for October 15.

Dr. Harold Frucht of Columbia University College of Physicians & Surgeons, New York-Presbyterian Hospital, and colleagues note that pancreatic cancer is the fourth leading cause of cancer deaths in most western countries. “Due to the rapid progression and almost uniform fatality of the disease, early detection through screening will be essential to improve outcomes,” they point out.

While no screening strategy is feasible for the general population, screening is thought worthwhile in individuals with a hereditary predisposition to develop pancreatic cancer.

The researchers report their initial experience with a high-risk pancreatic cancer screening program in which 51 subjects from 43 families were tested for mutations linked to hereditary cancer syndromes and followed prospectively with endoscopic ultrasound or MRI.

“Endoscopic ultrasound revealed two patients with pancreatic cancer (one resectable, one metastatic), five with intraductal papillary mucinous neoplasms (IPMN), seven with cysts, and six with parenchymal changes,” the team reports. Furthermore, four neoplasms at other sites were identified.

Nine patients underwent surgery with curative intent, except for the one case of metastatic pancreatic cancer. “All patients remain alive and without complications of screening,” Dr. Frucht and colleagues report.

They conclude, “Ongoing study will better define who will benefit from screening and what screening strategy will be the most effective.”

Reference:

Pancreatic Cancer Screening in a Prospective Cohort of High-Risk Patients: A Comprehensive Strategy of Imaging and Genetics

Clin Cancer Res 2010;16.