Elena M. Stoffel, MD, MPH
In a provisional clinical opinion (PCO), an expert panel convened by the American Society of Clinical Oncology (ASCO) has recommended that patients with pancreatic cancer undergo assessment of risk for hereditary syndromes that contribute to higher likelihood of pancreatic cancer. The PCO also defines criteria for those with a familial history of pancreatic cancer who should receive testing.1
The PCO recommends that a comprehensive review of family history of cancer be performed for patients with pancreatic cancer. Those with cancer affecting 2 firstdegree relatives fit the classification of having familial pancreatic cancer (FPC) under the PCO, and those with FPC and a history of 3 or more diagnoses of pancreatic cancer on the same side of the family, as well as patients identified as having genetic susceptibility for pancreatic cancer, are candidates for testing, according to the PCO. “Even if family cancer history is unremarkable,” it is appropriate to discuss genetic testing with individuals with a diagnosis of pancreatic cancer, the PCO states. The benefits and limitations of genetic testing for susceptibility should also be discussed with patients, the PCO states.
Table 1. Syndromes and Gene Mutations Associated With Pancreatic Cancer3
This approach to screening will help answer questions commonly asked by patients with pancreatic cancer about the significance their own cancer has for family members and how to prevent them from developing pancreatic cancer, Stoffel said.
Table 2. Modifiable Risk Factors Associated With Pancreatic Cancer7
“If 1 out of 10 patients with pancreatic cancer develops their cancer in the setting of a genetic predisposition syndrome, this has tremendous implications for management for them and their family members. One of the most common inherited cancer syndromes identified in families affected with pancreatic cancer is hereditary breast/ovarian cancer,” Stoffel said.
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