Pancreatic cancer screening is considered in individuals who are at high-risk of developing pancreatic cancer based on their family history of cancers. Whether or not a patient should be considered for pancreatic cancer screening requires an assessment by a physician or genetic counselor, and when possible, that evaluation should be at a center with pancreatic disease specialists. Anyone may request an appointment to assess their risk of developing pancreatic cancer, including relatives of people who have been diagnosed with pancreatic or other cancers. During the first appointment, the doctor takes a detailed family history and performs a physical exam. The family history is used to determine whether the person's risk of developing pancreatic cancer is average, moderate or high.
Blood tests may be administered to check glucose levels (because many people predisposed to pancreatic cancer develop diabetes), and to assess liver function, pancreatic function and other measures of health.
Some people will undergo imaging tests such as MRI scan and endoscopic ultrasound of the pancreas. Depending on the patients’ risk of developing pancreatic cancer, some people have just blood work or a combination of imaging and blood tests. The higher the risk, the closer the look we need to take at the pancreas and the pancreatic ducts.
Genetic testing may also be recommended. We are looking for particular syndromes that may include breast, ovarian, colon or others and also involve pancreatic cancer.
Certain syndromes predispose people to certain kinds of cancers. If we suspect that a syndrome may be present, we recommend genetic testing.
Depending on the results of these tests, the person's risk level may be reclassified. The team then determines how often to monitor the person. If an abnormality is found on imaging, the team decides whether to continue to monitor and the appropriate interval, which may be at three-, six-, or twelve-month intervals.