Endoscopic ultrasonography for surveillance of individuals at high risk for pancreatic cancer

Table 1 Genetic diseases associated with pancreatic cancer risk

Risk condition	Relative risk	Risk by age 70	Gene
Familial pancreatic cancer			PALLD
1 first-degree relative	2.3-4.5	2%	BRCA2
2 first-degree relatives	6.4-18	3%	PALB2
≥ 3 first-degree relatives	32-57	16%
Familial atypical multiple mole melanoma	13-38	15%-20%	CDKN2A/p16
Peutz-Jeghers Syndrome	132	11%-60%	STK11/LKB1
Hereditary pancreatitis	50-87	30%-75%	PRSS1
			PRSS2
			SPINK1
			CTRC
Cystic fibrosis	5.3	<5%	CFTR
Familial breast ovarian cancer	3.5-10	5%	BRCA2
	2.3-3.6	1%	BRCA1
Hereditary non-polyposis colon cancer	2.3-8.6	3%-4%	MLH1
			MSH2
			MSH6
Familial adenomatous polyposis	4.5-5	2%	FAP
			MUTYH
Li Fraumeni sindrome	Unknown	Unknown	TP53

Table 2 Endoscopic ultrasound-based studies on screening for individuals at risk for pancreatic cancer

Ref.	No. of patients	High-risk groups	Imaging test	Target lesions	Diagnostic yield	Limits of the study
Brentnall et al[21]	14	FPC	EUS + ERCP + CT	PanIN ≥ 2	50%
Kimmey et al[104]	46	FPC	EUS	PanIN ≥ 2	26%
Canto et al[22]	38	FPC, PJS	EUS	IPMN, PC	5.30%	Low PPV
Canto et al[23]	78	FPC, PJS	EUS	IPMN, PC, PanIN ≥ 2	10.20%
Poley et al[135]	44	FPC, PJS, FAMMM	EUS	IPMN, PC	22.70%	No pathological confirmation of IPMN
Langer et al[103]	76	FPC, FAMMM	EUS + MRCP	IPMN	1.30%	Moderate risk patients
Verna et al[162]	51	FPC, FBOC	EUS and/or MRCP	IPMN, PC, PanIN ≥ 2	12%
Schneider et al[36]	72	FPC, FAMMM	EUS + MRCP	IPMN	12.50%	No pathological confirmation
Canto et al[110]	216	FPC, FBOC, PJS	EUS + CT + MRCP	IPMN, PC	39%	Mainly no pathological confirmation

FPC: Familial pancreatic cancer; PJS: Peutz-Jeghers syndrome; FAMMM: Familial atypical multiple mole melanoma; FBOC: Familial breast ovarian cancer; EUS: Endoscopic ultrasonography; ERCP: Endoscopic retrograde cholangiopancreatography; CT: Computed tomography; MRCP: Magnetic resonance cholangiopancreatography; PanIN: Pancreatic intraepithelial neoplasia; IPMN: Intraductal pancreatic mucinous neoplasia; PC: Pancreatic cancer; PPV: Positive predictive value.