Results of First-Round of Surveillance in Individuals at High-Risk of Pancreatic Cancer from the AISP (Italian Association for the Study of the Pancreas) Registry

Salvatore Paiella, Gabriele Capurso, Giulia Martina Cavestro, Giovanni Butturini, Raffaele Pezzilli, Roberto Salvia, Marianna Signoretti, Stefano Crippa, Silvia Carrara, Isabella Frigerio, Claudio Bassi, Massimo Falconi, Elsa Iannicelli, Alessandro Giardino, Alessandro Mannucci, Andrea Laghi, Luigi Laghi, Luca Frulloni, Alessandro Zerbi

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Surveillance programs on high-risk individuals (HRIs) can detect pre-malignant lesions or early pancreatic cancer (PC). We report the results of the first screening round of the Italian multicenter program supported by the Italian Association for the study of the Pancreas (AISP).

METHODS: The multicenter surveillance program included asymptomatic HRIs with familial (FPC) or genetic frailty (GS: BRCA1/2, p16/CDKN2A, STK11/LKB1or PRSS1, mutated genes) predisposition to PC. The surveillance program included at least an annual magnetic resonance cholangio pancreatography (MRCP). Endoscopic ultrasound (EUS) was proposed to patients who refused or could not be submitted to MRCP.

RESULTS: One-hundreds eighty-seven HRIs underwent a first-round screening examination with MRCP (174; 93.1%) or EUS (13; 6.9%) from September 2015 to March 2018.The mean age was 51 years (range 21-80).One-hundreds sixty-five (88.2%) FPC and 22 (11.8%) GF HRIs were included. MRCP detected 28 (14.9%) presumed branch-duct intraductal papillary mucinous neoplasms (IPMN), 1 invasive carcinoma/IPMN and one low-grade mixed-type IPMN, respectively. EUS detected 4 PC (2.1%): 1 was resected, 1 was found locally advanced intraoperatively, and 2 were metastatic. Age > 50 (OR 3.3, 95%CI 1.4-8), smoking habit (OR 2.8, 95%CI 1.1-7.5), and having > 2 relatives with PC (OR 2.7, 95%CI 1.1-6.4) were independently associated with detection of pre-malignant and malignant lesions. The diagnostic yield for MRCP/EUS was 24% for cystic lesions. The overall rate of surgery was 2.6% with nil mortality.

DISCUSSION: The rate of malignancies found in this cohort was high (2.6%). According to the International Cancer of the Pancreas Screening Consortium the screening goal achievement was high (1%).

Original languageEnglish
Pages (from-to)665-670
Number of pages6
JournalThe American journal of gastroenterology
Volume114
Issue number4
DOIs
Publication statusPublished - Apr 2019

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Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Cholangiopancreatography, Magnetic Resonance
  • Early Detection of Cancer
  • Endosonography
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Italy/epidemiology
  • Male
  • Middle Aged
  • Pancreatic Neoplasms/diagnostic imaging
  • Population Surveillance
  • Registries
  • Risk Factors

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