Management of patients with increased risk for familial pancreatic cancer: updated recommendations from the International Cancer of the Pancreas Screening (CAPS) Consortium

摘要: Background and aim: The International Cancer of the Pancreas Screening Consortium met in 2018 to update its consensus recommendations for management individuals with increased risk pancreatic cancer based on family history or germline mutation status (high-risk individuals). Methods: A modified Delphi approach was employed reach among a multidisciplinary group experts who voted statements. Consensus considered reached if ≥75% agreed disagreed. Results: 55 main goals surveillance (to identify high-grade dysplastic precursor lesions T1N0M0 cancer) remained unchanged. Experts that those familial risk, should start no earlier than age 50 10 years youngest relative cancer, but were split whether at 55. Germline ATM carriers one affected first-degree are now eligible surveillance. preferred tests endoscopic ultrasound MRI/magnetic retrograde cholangiopancreatography, how alternate these modalities. Annual is recommended absence concerning lesions. Main areas disagreement included be performed hereditary pancreatitis, indeterminate Conclusions: Pancreatic selected high-risk detect early precursors, research setting by teams centres appropriate expertise. Until more evidence supporting available, benefits, risks costs need additional evaluation.