What are international CAPS consortium guidelines for pancreatic cancer screening?

Updated: Mar 07, 2019
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

In 2012, the International CAPS Consortium, a panel of 49 multidisciplinary experts, released consensus guidelines for pancreatic cancer screening. While also recommending against routine screening in the general population, the members recommended screening with endoscopic ultrasound (EUS) and/or magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) for the following high-risk groups [91] :

  • Individuals with two or more blood relatives, and at least one first-degree relative, with pancreatic cancer

  • Carriers of p16PALB2, or BRCA2 mutations with a first-degree relative with pancreatic cancer

  • All individuals with Peutz-Jeghers syndrome

  • Individuals with Lynch syndrome and a first-degree relative with pancreatic cancer

(In practice, however, many carriers of p16PALB2, or BRCA2 mutations opt for screening even if they do not have a relative with the disease.)

The panel agreed that to be considered successful, screening should detect and lead to treatment of T1N0M0 margin-negative pancreatic cancer and high-grade dysplastic precursor lesions (pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasm). However, the group did not reach consensus on the optimal management of detected lesions, the age to begin screening, or screening intervals.


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