International Cancer of the Pancreas Screening (CAPS) Consortium summit on the management of patients with increased risk for familial pancreatic cancer.

Canto, MI; Harinck, F; Hruban, RH; Offerhaus, GJ; Poley, JW; Kamel, I; Nio, Y; Schulick, RS; Bassi, C; Kluijt, I; Levy, MJ; Chak, A; Fockens, P; Goggins, M; Bruno, M; International Cancer of Pancreas Screening (CAPS) Consortium; Arcidiacono, PG; Bartsch, D; Biermann, K; Brentnall, T; Chak, A; Dite, P; Donahue, T; Early, D; Farrell, J; Fernandez-Del Castillo, C; Frucht, H; Fukushima, N; Geurts, J; Hamell, P; Iglesias-Garcia, J; Klein, A; Kloeppel, G; Lachter, J; Langer, P; Lee, J; Levy, M; Maguchi, H; Margolis, D; Ohtsuka, T; Olson, S; Petersen, G; Savides, T; Syngal, S; Tamm, E; Tanaka, M; Vasen, H; Wagner, A; Wang, H; Williams, D; Yamao, K     «

Canto, MI; Harinck, F; Hruban, RH; Offerhaus, GJ; Poley, JW; Kamel, I; Nio, Y; Schulick, RS; Bassi, C; Kluijt, I; Levy, MJ; Chak, A; Fockens, P; Goggins, M; Bruno, M; International Cancer of Pancreas Screening (CAPS) Consortium; Arcidiacono, PG; Bartsch, D; Biermann, K; Brentnall, T; Chak, A; Dite, P; Donahue, T; Early, D; Farrell, J; Fernandez-Del Castillo, C; Frucht, H; Fukushima, N; Geurts, J; Hamell, P; Iglesias-Garcia, J; Klein, A; Kloeppel, G; Lachter, J; Langer, P; Lee, J; Levy, M; Maguch...     »

Screening individuals at increased risk for pancreatic cancer (PC) detects early, potentially curable, pancreatic neoplasia.To develop consortium statements on screening, surveillance and management of high-risk individuals with an inherited predisposition to PC.A 49-expert multidisciplinary international consortium met to discuss pancreatic screening and vote on statements. Consensus was considered reached if>>= 75% agreed or disagreed.There was excellent agreement that, to be successful, a screening programme should detect and treat T1N0M0 margin-negative PC and high-grade dysplastic precursor lesions (pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasm). It was agreed that the following were candidates for screening: first-degree relatives (FDRs) of patients with PC from a familial PC kindred with at least two affected FDRs; patients with Peutz-Jeghers syndrome; and p16, BRCA2 and hereditary non-polyposis colorectal cancer (HNPCC) mutation carriers with>= 1 affected FDR. Consensus was not reached for the age to initiate screening or stop surveillance. It was agreed that initial screening should include endoscopic ultrasonography (EUS) and/or MRI/magnetic resonance cholangiopancreatography not CT or endoscopic retrograde cholangiopancreatography. There was no consensus on the need for EUS fine-needle aspiration to evaluate cysts. There was disagreement on optimal screening modalities and intervals for follow-up imaging. When surgery is recommended it should be performed at a high-volume centre. There was great disagreement as to which screening abnormalities were of sufficient concern to for surgery to be recommended.Screening is recommended for high-risk individuals, but more evidence is needed, particularly for how to manage patients with detected lesions. Screening and subsequent management should take place at high-volume centres with multidisciplinary teams, preferably within research protocols.     «

Screening individuals at increased risk for pancreatic cancer (PC) detects early, potentially curable, pancreatic neoplasia.To develop consortium statements on screening, surveillance and management of high-risk individuals with an inherited predisposition to PC.A 49-expert multidisciplinary international consortium met to discuss pancreatic screening and vote on statements. Consensus was considered reached if>>= 75% agreed or disagreed.There was excellent agreement that, to be successful, a scr...     »