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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2023; 77(6): 529–538. doi: 10.48095/ccgh2023529.

Pancreatic cancer surveillance in high-risk individuals Position statement of professional societies



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Keywords

screening, pancreatic carcinoma, surveillance, high-risk individuals

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Literature

1. Krejčí D, Pehalová L, Talábová A et al. Současné epidemiologické trendy novotvarů v České republice. Novotvary 2018 ČR. ÚZIS. Dostupné z: https: //www.uzis.cz/res/f/008352/novotvary2018.pdf.
2. Loveček M, Skalický P, Ryska M et al. Aktuální stav chirurgické léčby karcinomu pankreatu v České republice. Rozhl Chir 2016; 95(4): 151–162.
3. Huang L, Jansen L, Balavarca Y et al. Resection of pancreatic cancer in Europe and USA: an international large-scale study highlighting large variations. Gut 2019; 68(1): 130–139. doi: 10.1136/gutjnl-2017-314828.
4. Yu J, Blackford AL, Dal Molin M et al. Time to progression of pancreatic ductal adenocarcinoma from low-to-high tumour stages. Gut 2015; 64(11): 1783–1789. doi: 10.1136/gut jnl-2014-308653.
5. National Cancer Institute. Cancer Stat Facts: Pancreatic Cancer. 2021 [online]. Dostupné z: https: //seer.cancer.gov/statfacts/html/pancreas.html.
6. Ryska M. Karcinom pankreatu – současný efektivní diagnosticko-terapeutický postup. Cas Lek Cesk 2016; 155(1): 38–43.
7. Aslanian HR, Lee JH, Canto MI. AGA Clinical Practice Update on Pancreas Cancer Screening in High-Risk Individuals: Expert Review. Gastroenterology 2020; 159(1): 358–362. doi: 10.1053/ j.gastro.2020.03.088.
8. Owens DK, Davidson KW, Krist AH et al. Screening for pancreatic cancer: US preventive services Task force reaffirmation recommendation statement. JAMA 2019; 322(5): 438–444. doi: 10.1001/jama.2019.10232.
9. Seufferlein T, Mayerle J, Böck S et al. S3-Leitlinie zum exokrinen Pankreaskarzinom – Langversion 2.0 – Dezember 2021 – AWMF-Registernummer: 032/010OL. Z Gastroenterol 2022; 60(11): e812–e909. doi: 10.1055/a-1856-7346.
10. Goggins M, Overbeek KA, Brand R et al. Management of patients with increased risk for familial pancreatic cancer: updated recommendations from the International Cancer of the Pancreas Screening (CAPS) Consortium. Gut 2020; 69(1): 7–17. doi: 10.1136/gutjnl-2019-319 352.
11. Syngal S, Brand RE, Church JM et al. American College of Gastroenterology. ACG clinical guideline: Genetic testing and management of hereditary gastrointestinal cancer syndromes. Am J Gastroenterol 2015; 110(2): 223–262; quiz 263. doi: 10.1038/ajg.2014.435.
12. Henrikson NB, Aiello Bowles EJ, Blasi PR et al. Screening for pancreatic cancer: updated evidence report and systematic review for the US preventive services Task force. JAMA 2019; 322: 445–454. doi: 10.1001/jama.2019.6190.
13. Vaněk P, Slodička P, Tichý T et al. Screening karcinomu pankreatu: Nastal čas vykročit? Gastroent Hepatol 2021; 75(5): 390–398. doi: 10.48095/ccgh2021390.
14. Vaněk P, Urban O, Zoundjiekpon V et al. Current Screening Strategies for Pancreatic Cancer. Biomedicines 2022; 10 (9): 2056. doi: 10.3390/biomedicines10092056.
15. Canto MI, Harinck F, Hruban RH, et al. International Cancer of the Pancreas Screening (CAPS) Consortium summit on the management of patients with increased risk for familial pancreatic cancer. Gut 2013; 62(3): 339–347. doi: 10.1136/gutjnl-2012-303108.
16. Klein AP, Brune KA, Petersen GM et al. Prospective risk of pancreatic cancer in familial pancreatic cancer kindreds. Cancer Res 2004; 64(7): 2634–2638. doi: 10.1158/0008-5472.can-03-3823.
17. Schneider R, Slater EP, Sina M et al. German national case collection for familial pancreatic cancer (FaPaCa): ten-year experience. Fam Cancer 2011; 10(2): 323–330. doi: 10.1007/s106 89-010-9414-x.
18. Chen F, Childs EJ, Mocci E et al. Analysis of Heritability and Genetic Architecture of Pancreatic Cancer: A PanC4 Study. Cancer Epidemiol Biomarkers Prev 2019; 28(7): 1238–1245. doi: 10.1158/1055-9965.EPI-18-1235.
19. Lowenfels AB, Maisonneuve P, Whitcomb DC. Risk factors for cancer in hereditary pancreatitis. International Hereditary Pancreatitis Study Group. Med Clin North Am 2000; 84(3): 565–573. doi: 10.1016/s0025-7125 (05) 70240-6.
20. Yeo TP, Hruban RH, Brody J et al. Assessment of „gene-environment“ interaction in cases of familial and sporadic pancreatic cancer. J Gastrointest Surg 2009; 13(8): 1487–1494. doi: 10.1007/s11605-009-0923-6.
21. Seppälä TT, Burkhart RA, Katona BW. Hereditary colorectal, gastric, and pancreatic cancer: comprehensive review. BJS Open 2023; 7(3): zrad023. doi: 10.1093/bjsopen/zrad023.
22. Giardiello FM, Brensinger JD, Tersmette AC et al. Very high risk of cancer in familial Peutz-Jeghers syndrome. Gastroenterology 2000; 119(6): 1447–1453. doi: 10.1053/gast.2000.20 228.
23. van Lier MG, Wagner A, Mathus-Vliegen EM et al. High cancer risk in Peutz-Jeghers syndrome: a systematic review and surveillance recommendations. Am J Gastroenterol 2010; 105(6): 1258–1264. doi: 10.1038/ajg.2009.725.
24. DaVee T, Coronel E, Papafragkakis C et al. Pancreatic cancer screening in high-risk individuals with germline genetic mutations. Gastrointest Endosc 2018; 87(6): 1443–1450. doi: 10.1016/j.gie.2017.12.019.
25. Vasen HF, Gruis NA, Frants RR et al. Risk of developing pancreatic cancer in families with familial atypical multiple mole melanoma associated with a specific 19 deletion of p16 (p16-Leiden). Int J Cancer 2000; 87(6): 809–811.
26. Goldstein AM, Fraser MC, Struewing JP et al. Increased risk of pancreatic cancer in melanoma-prone kindreds with p16INK4 mutations. N Engl J Med 1995; 333(15): 970–974. doi: 10.1056/NEJM199510123331504.
27. Yang X, Leslie G, Doroszuk A et al. Cancer Risks Associated With Germline PALB2 Pathogenic Variants: An International Study of 524 Families. J Clin Oncol 2020; 38(7): 674–685. doi: 10.1200/JCO.19.01907.
28. Dite P, Hermanova M, Trna J et al. The role of chronic inflammation: chronic pancreatitis as a risk factor of pancreatic cancer. Dig Dis 2012; 30(3): 277–283. doi: 10.1159/000336991.
29. Lowenfels AB, Maisonneuve P, DiMagno EP et al. Hereditary pancreatitis and the risk of pancreatic cancer. J Natl Cancer Inst 1997; 89(6): 442–446. doi: 10.1093/jnci/89.6.442.
30. Rebours V, Boutron-Ruault MC, Schnee M et al. Risk of pancreatic adenocarcinoma in patients with hereditary pancreatitis: a national exhaustive series. Am J Gastroenterol 2008; 103(1): 111–119. doi: 10.1111/j.1572-0241.2007.01597.x.
31. Kastrinos F, Mukherjee B, Tayob N et al. Risk of pancreatic cancer in families with Lynch syndrome. JAMA 2009; 302(16): 1790–1795. doi: 10.1001/jama.2009.1529.
32. Stoffel EM, McKernin SE, Brand R et al. Evaluating Susceptibility to Pancreatic Cancer: ASCO Provisional Clinical Opinion. J Clin Oncol 2019; 37(2): 153–164. doi: 10.1200/JCO.18.01489.
33. National Comprehensive Cancer Network. NCCN Guidelines – Pancreatic Adenocarcinoma. 2023 [online]. Dostupné z: https: //www.nccn.org/guidelines/guidelines-detail?category=1&id=1455.
34. Lowery MA, Wong W, Jordan EJ et al. Prospective Evaluation of Germline Alterations in Patients With Exocrine Pancreatic Neoplasms. J Natl Cancer Inst 2018; 110(10): 1067–1074. doi: 10.1093/jnci/djy024.
35. Grant RC, Selander I, Connor AAp et al. Prevalence of germline mutations in cancer predisposition genes in patients with pancreatic cancer. Gastroenterology 2015; 148(3): 556–564. doi: 10.1053/j.gastro.2014.11.042.
36. Salo-Mullen EE, O‘Reilly EM, Kelsen DP et al. Identification of germline genetic mutations in patients with pancreatic cancer. Cancer 2015; 121(24): 4382–4388. doi: 10.1002/cncr.29664.
37. Yurgelun MB, Chittenden AB, Morales-Oyarvide V et al. Germline cancer susceptibility gene variants, somatic second hits, and survival outcomes in patients with resected pancreatic cancer. Genet Med 2019; 21(1): 213–223. doi: 10.1038/s41436-018-0009-5.
38. Brand R, Borazanci E, Speare V et al. Prospective study of germline genetic testing in incident cases of pancreatic adenocarcinoma. Cancer 2018; 124(17): 3520–3527. doi: 10.1002/cncr.31628.
39. Dudley B, Karloski E, Monzon FA et al. Germline mutation prevalence in individuals with pancreatic cancer and a history of previous malignancy. Cancer 2018; 124(8): 1691–1700. doi: 10.1002/cncr.31242.
40. Shindo K, Yu J, Suenaga M et al. Deleterious Germline Mutations in Patients With Apparently Sporadic Pancreatic Adenocarcinoma. J Clin Oncol 2017; 35(30): 3382–3390. Doi: 10.1200/JCO.2017.72.3502.
41. Zemanek T, Melichar B, Lovecek M et al. Biomarkers and pathways of chemoresistance and chemosensitivity for personalized treatment of pancreatic adenocarcinoma. Pharmacogenomics 2019; 20(2): 113–127. doi: 10.2217/pgs- 2018-0073.
42.Canto MI, Hruban RH, Fishman EK et al. Frequent detection of pancreatic lesions in asymptomatic high-risk individuals. Gastroenterology 2012; 142(4): 796-804. doi: 10.1053/ j.gastro.2012.01.005.
43. Overbeek KA, Levink IJM, Koopmann BDM et al. Long-term yield of pancreatic cancer surveillance in high-risk individuals. Gut 2022; 71(6): 1152–1160. doi: 10.1136/gutjnl-2020-323611.
44. Harinck F, Konings IC, Kluijt I et al. A multicentre comparative prospective blinded analysis of EUS and MRI for screening of pancreatic cancer in high-risk individuals. Gut 2016; 65(9): 1505–1513. doi: 10.1136/gutjnl-2014-308008.
45. Canto MI, Almario JA, Schulick RD et al. Risk of Neoplastic Progression in Individuals at High Risk for Pancreatic Cancer Undergoing Long-term Surveillance. Gastroenterology 2018; 155(3): 740.e2–751.e2. doi: 10.1053/j.gastro.2018. 05.035.
46. Psar R, Urban O, Cerna M et al. Improvement of the Diagnosis of Isoattenuating Pancreatic Carcinomas by Defining Their Characteristics on Contrast Enhanced Computed Tomography and Endosonography with Fine-Needle Aspiration (EUS-FNA). Diagnostics 2021; 11(5): 776. doi: 10.3390/diagnostics11050776.
47. Dbouk M, Katona BW, Brand RE et al. The Multicenter Cancer of Pancreas Screening Study: Impact on Stage and Survival. J Clin Oncol 2022; 40(28): 3257–3266. doi: 10.1200/JCO.22.00298.
48. Sawhney MS, Calderwood AH, Thosani NC et al. ASGE guideline on screening for pancreatic cancer in individuals with genetic susceptibility: summary and recommendations. Gastrointest Endosc 2022; 95(5): 817–826. doi: 10.1016/ j.gie.2021.12.001.
49. Danai LV, Babic A, Rosenthal MH et al. Altered exocrine function can drive adipose wasting in early pancreatic cancer. Nature 2018; 558(7711): 600–604. doi: 10.1038/s41586-018-0235-7.
50. Sah RP, Sharma A, Nagpal S et al. Phases of Metabolic and Soft Tissue Changes in Months Preceding a Diagnosis of Pancreatic Ductal Adenocarcinoma. Gastroenterology 2019; 156(6): 1742–1752. doi: 10.1053/j.gastro.2019.01.039.
51. Canto MI, Goggins M, Hruban RH et al. Screening for early pancreatic neoplasia in high-risk individuals: a prospective controlled study. Clin Gastroenterol Hepatol 2006; 4(6): 766–781. doi: 10.1016/j.cgh.2006.02.005.
52. Hanada K, Minami T, Shimizu A et al. Roles of ERCP in the Early Diagnosis of Pancreatic Cancer. Diagnostics 2019; 9(1): 30. doi: 10.3390/diagnostics9010030.
53. Kanno Y, Koshita S, Ogawa T et al. Predictive Value of Localized Stenosis of the Main Pancreatic Duct for Early Detection of Pancreatic Cancer. Clin Endosc 2019; 52(6): 588–597. doi: 10.5946/ce.2019.018.
54. Wu J, Matthaei H, Maitra A et al. Recurrent GNAS mutations define an unexpected pathway for pancreatic cyst development. Sci Transl Med 2011; 3(92): 92ra66. doi: 10.1126/scitransl med.3002543.
55. Kanda M, Knight S, Topazian M et al. Mutant GNAS detected in duodenal collections of secretin-stimulated pancreatic juice indicates the presence or emergence of pancreatic cysts. Gut 2013; 62(7): 1024–1033. doi: 10.1136/gutjnl-2012-302823.
56. Kanda M, Sadakari Y, Borges M et al. Mutant TP53 in duodenal samples of pancreatic juice from patients with pancreatic cancer or high-grade dysplasia. Clin Gastroenterol Hepatol 2013; 11(6): 719.e5–730.e5. doi: 10.1016/ j.cgh.2012.11.016.
57. Zubarik R, Gordon SR, Lidofsky SD et al. Screening for pancreatic cancer in a high-risk population with serum CA 19-9 and targeted EUS: a feasibility study. Gastrointest Endosc 2011; 74(1): 87–95. doi: 10.1016/j.gie.2011.03. 1235.
58. Cohen JD, Li L, Wang Y et al. Detection and localization of surgically resectable cancers with a multi-analyte blood test. Science 2018; 359(6378): 926–930. doi: 10.1126/science.aar3247.
59. Liu J, Gao J, Du Y et al. Combination of plasma microRNAs with serum CA19-9 for early detection of pancreatic cancer. Int J Cancer 2012; 131(3): 683–691. doi: 10.1002/ijc.26422.
60. Wolrab D, Jirasko R, Cifková E et al. Lipidomic profiling of human serum enables detection of pancreatic cancer. Nat Commun 2022; 13(1): 124. doi: 10.1038/s41467-021-27765-9.
61. Sharma A, Kandlakunta H, Nagpal SJS et al. Model to Determine Risk of Pancreatic Cancer in Patients With New-Onset Diabetes. Gastroenterology 2018; 155(3): 730.e3–739.e3. do: 10.1053/j.gastro.2018.05.023.
62. Sharma A, Smyrk TC, Levy MJ et al. Fasting Blood Glucose Levels Provide Estimate of Duration and Progression of Pancreatic Cancer Before Diagnosis. Gastroenterology 2018; 155(2): 490.e2–500.e2. doi: 10.1053/j.gastro.2018.04.025.
63.Khan S, Safarudin RF, Kupec JT. Validation of the ENDPAC model: Identifying new-onset diabetics at risk of pancreatic cancer. Pancreatology 2021; 21(3): 500–555. doi: 10.1016/ j.pan.2021.02.001.
64. Chen W, Butler RK, Lustigova E et al. Validation of the Enriching New-Onset Diabetes for Pancreatic Cancer Model in a Diverse and Integrated Healthcare Setting. Dig Dis Sci 2021; 66(1): 78–87. doi: 10.1007/s10620-020-06139-z.
65. Frič P, Šedo A, Škrha J et al. Časná detekce sporadického karcinomu pankreatu. Čas Lék Čes 2016; 155(1): 44–47.
66. Bures J, Kohoutova D, Skrha J et al. Diabetes Mellitus in Pancreatic Cancer: A Distinct Approach to Older Subjects with New-Onset Diabetes Mellitus. Cancers (Basel) 2023; 15(14): 3669. doi: 10.3390/cancers15143669.
67. Vasen H, Ibrahim I, Ponce CG et al. Benefit of Surveillance for Pancreatic Cancer in High-Risk Individuals: Outcome of Long-Term Prospective Follow-Up Studies From Three European Expert Centers. J Clin Oncol 2016; 34(17): 2010–2019. doi: 10.1200/JCO.2015.64.0730.
68. Sawhney MS, Calderwood AH, Thosani NC et al. ASGE guideline on screening for pancreatic cancer in individuals with genetic susceptibility: summary and recommendations. Gastrointest Endosc 2022; 95(5): 817–826. doi: 10.1016/j.gie.2021.12.001.
69. Roberts NJ, Norris AL, Petersen GM et al. Whole Genome Sequencing Defines the Genetic Heterogeneity of Familial Pancreatic Cancer. Cancer Discov 2016; 6(2): 166–175. doi: 10.1158/2159-8290.CD-15-0402.
70. Bartsch DK, Dietzel K, Bargello M et al. Multiple small “imaging” branch-duct type intraductal papillary mucinous neoplasms (IPMNs) in familial pancreatic cancer: indicator for concomitant high grade pancreatic intraepithelial neoplasia? Fam Cancer 2013; 12(1): 89–96. doi: 10.1007/s10689-012-9582-y.
71. Brune K, Abe T, Canto M et al. Multifocal neoplastic precursor lesions associated with lobular atrophy of the pancreas in patients having a strong family history of pancreatic cancer. Am J Surg Pathol 2006; 30(9): 1067–1076.
72. Canto MI, Goggins M, Yeo CJ et al. Screening for pancreatic neoplasia in high-risk individuals: an EUS-based approach. Clin Gastroenterol Hepatol 2004; 2(7): 606–621. doi: 10.1016/s1542-3565 (04) 00244-7.
73. Lang J, Kunovsky L, Kala Z et al. Risk factors of pancreatic cancer and their possible uses in diagnostics. Neoplasma 2021; 68(2): 227–239. doi: 10.4149/neo_2020_200706N699.
74. Vasen HF, Wasser M, van Mil A et al. Magnetic resonance imaging surveillance detects early-stage pancreatic cancer in carriers of a p16-Leiden mutation. Gastroenterology 2011; 140(3): 850–856. doi: 10.1053/j.gastro.2010.11.048.
75. Konings IC, Sidharta GN, Harinck F et al. Repeated participation in pancreatic cancer surveillance by high-risk individuals imposes low psychological burden. Psychooncology 2016; 25(8): 971–978. doi: 10.1002/pon.4047.
76. Shah I, Silva-Santisteban A, Germansky KA et al. Pancreatic Cancer Screening for At-Risk Individuals (Pancreas Scan Study): Yield, Harms, and Outcomes From a Prospective Multicenter Study. Am J Gastroenterol 2023; 118(9): 1664–1670. doi: 10.14309/ajg.000000000000214.
77. Al-Sukhni W, Borgida A, Rothenmund H et al. Screening for pancreatic cancer in a high-risk cohort: an eight-year experience. J Gastrointest Surg 2012; 16(4): 771–783. doi: 10.1007/s11605-011-1781-6.
78. Yu J, Sadakari Y, Shindo K et al. Digital next-generation sequencing identifies low-abundance mutations in pancreatic juice samples collected from the duodenum of patients with pancreatic cancer and intraductal papillary mucinous neoplasms. Gut 2017; 66(9): 1677–1687. doi: 10.1136/gutjnl-2015-311166.
79. Suenaga M, Yu J, Shindo K et al. Pancreatic Juice Mutation Concentrations Can Help Predict the Grade of Dysplasia in Patients Undergoing Pancreatic Surveillance. Clin Cancer Res 2018; 24(12): 2963–2974. doi: 10.1158/1078-0432.CCR-17-2463.
80. Pea A, Yu J, Marchionni L et al. Genetic Analysis of Small Well-differentiated Pancreatic Neuroendocrine Tumors Identifies Subgroups With Differing Risks of Liver Metastases. Ann Surg 2020; 271(3): 566–573. doi: 10.1097/SLA.0000000000003022.
81. Falconi M, Eriksson B, Kaltsas G et al. ENETS Consensus Guidelines Update for the Management of Patients with Functional Pancreatic Neuroendocrine Tumors and Non-Functional Pancreatic Neuroendocrine Tumors. Neuroendocrinology 2016; 103(2): 153–171. doi: 10.1159/000443171.
82. Matthaei H, Hong SM, Mayo SC et al. Presence of pancreatic intraepithelial neoplasia in the pancreatic transection margin does not influence outcome in patients with R0 resected pancreatic cancer. Ann Surg Oncol 2011; 18(12): 3493–3499. doi: 10.1245/s10434-011-17 45-9.
83. Basturk O, Hong SM, Wood LD et al. A Revised Classification System and Recommendations From the Baltimore Consensus Meeting for Neoplastic Precursor Lesions in the Pancreas. Am J Surg Pathol 2015; 39(12): 1730–1741. doi: 10.1097/PAS.0000000000000533.
84. Canto MI, Kerdsirichairat T, Yeo CJ et al. Surgical Outcomes After Pancreatic Resection of Screening-Detected Lesions in Individuals at High Risk for Developing Pancreatic Cancer. J Gastrointest Surg 2020; 24(5): 1101–1110. doi: 10.1007/s11605-019-042 30-zy.
85. Bagias G, Kanavidis P, Vailas M et al. Surgical management of familial pancreatic cancer: a systematic review of the literature. ANZ J Surg 2022; 92(11): 2816–2821. doi: 10.1111/ans.17834.

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