Pancreatic ductal adenocarcinoma: Risk factors, screening, and early detection

Table 3 Pancreatic ductal adenocarcinomas screening efforts and diagnostic yields n (%)

Ref.	Number screened	High-risk group	Initial imaging (if abnormal screening)	Diagnostic yield	Definition of diagnostic yield
Brentnall et al[182]	14	FPC	EUS + ERCP + CT	7 (50)	Dysplasia
Rulyak et al[183]	35	FPC	If symptomatic: EUS + ERCP If asymptomatic: EUS (ERCP)	12 (34.3)	Dysplasia
Kimmey et al[184]	46	FPC	EUS (ERCP)	12 (26)	Dysplasia
Canto et al[185]	38	FPC, PJS	EUS (CT, ERCP, EUS-FNA)	2 (5.3)	PDAC, IPMN
Canto et al[186]	78	FPC, PJS	EUS + CT (ERCP, EUS-FNA)	8 (10.3)	IPMN, PanIN1-2
Poley et al[187]	44	FPC, BRCA, PJS, FAMMM, p53, HP	EUS (CT, MRI)	10 (23)	PDAC, IPMN on imaging
Langer et al[188]	76	FPC, BRCA, FAMMM	EUS + MRCP (EUS)	1 (1.3)	IPMN
Verna et al[181]	51	FPC, PJS, FAMMM, BRCA, HP, HNPCC	EUS and/or MRCP (EUS-FNA, ERCP)	6 (12)1	PDAC, IPMN, multifocal PanIN2-3
Ludwig et al[189]	109	FPC, BRCA	MRCP (EUS)	9 (8.3)	PDAC, IPMN, PanIN2-3, SCA on imaging
Vasen et al[190]	79	p16	MRI/MRCP, EUS if unable	7 (8.9)	PDAC
Al-Sukhni et al[191]	262	FPC, FDR of double-primary cancer, BRCA, PJS, HP, p16	MRI (ERCP, EUS, CT)	3 (1.1)2	PDAC
Schneider et al[33]	72	FPC, BRCA, PALB2, p16	EUS + MRCP (EUS)	4 (5.5)	MD-IMPN, multifocal PanIN23
				9 (12.5)	MD-IMPN, multifocal PanIN2-3, BD-IPMN
Canto et al[174]	216	FPC, BRCA, PJS	CT + MRI/MRCP + EUS (ERCP)	92 (42.6)	Pancreatic lesion

¹Only 41 patients had imaging, resulting in yield of 14.6% (6/41);

²Only 175 patients had imaging, resulting in yield of 1.7% (3/175). PDAC: Pancreatic ductal adenocarcinomas; HNPCC: Lynch syndrome; FAP: Familial adenomatous polyposis; PJS: Peutz-Jeghers syndrome; FAMMM: Familial atypical multiple mole melanoma syndrome; HP: Hereditary pancreatitis; FPC: Familial pancreatic cancer; endoscopic retrograde MRI: Magnetic resonance imaging; CT: Computed tomography; EUS: Endoscopic ultrasonography; ERCP: Endoscopic retrograde cholangiopancreatography; MCN: Mucinous cystic neoplasms ; IPMN: Intraductal mucinous cystic neoplasm; FNA: Fine needle aspirate.