Cancer surveillance awareness and practice among families at increased risk for pancreatic adenocarcinoma - PubMed (original) (raw)

. 2021 Jul 1;127(13):2271-2278.

doi: 10.1002/cncr.33500. Epub 2021 Mar 15.

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Cancer surveillance awareness and practice among families at increased risk for pancreatic adenocarcinoma

Jessica N Everett et al. Cancer. 2021.

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Abstract

Background: Early detection of pancreatic ductal adenocarcinoma (PDAC) is an important goal for improving survival. Individuals who meet published guidelines for surveillance may be underidentified, and family communication about risk represents a pathway to increasing participation in surveillance. We investigated the uptake of and barriers to surveillance in at-risk relatives of clinic patients.

Methods: We conducted a retrospective record review of patients with personal or family history of PDAC evaluated over 12 months. The first relative presenting to clinic (proband) reported surveillance status and reasons for nonparticipation for at-risk relatives. Descriptive analyses and Fisher's exact tests were conducted to evaluate differences in surveillance participation.

Results: Among 193 at-risk relatives, 21% were in surveillance. The primary reasons for nonparticipation were lack of awareness (36%) and lack of interest (24%). Neither the sex nor the cancer status of probands impacted surveillance. At-risk relatives with familial pancreatic cancer (FPC) who also carried relevant pathogenic germline variants (PGVs) were more likely to undergo surveillance than those with FPC or PGVs alone (P = .003). Among families with PGVs, 59% of relatives potentially eligible for surveillance had not completed genetic testing.

Conclusion: PDAC surveillance is underutilized in high-risk families. Communication interventions to address informational needs and decisional support could improve outcomes.

Keywords: cancer surveillance; family communication; family history; germline variants; pancreatic cancer.

© 2021 American Cancer Society.

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References

    1. Rahib L, Smith BD, Aizenberg R, Rosenzweig AB, Fleshman JM, Matrisian LM. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res. 2014;74:2913-2921.
    1. Balaban EP, Mangu PB, Yee NS. Locally advanced unresectable pancreatic cancer: American Society of Clinical Oncology clinical practice guideline summary. J Oncol Pract. 2017;13:265-269.
    1. Surveillance, Epidemiology, and End Results Program (SEER) Explorer. 2010-2016. https://seer.cancer.gov/statfacts/html/pancreas.html. Accessed August 2020.
    1. Ishikawa O, Ohigashi H, Imaoka S, et al. Minute carcinoma of the pancreas measuring 1 cm or less in diameter-collective review of Japanese case reports. Hepatogastroenterology. 1999;46:8-15.
    1. Goggins M, Overbeek KA, Brand R, et al. Management of patients with increased risk for familial pancreatic cancer: updated recommendations from the International Cancer of the Pancreas Screening (CAPS) Consortium. Gut. 2020;69:7-17.

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