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Table 3 Summary of the main recommendations of the 2019 International Cancer of the Pancreas Surveillance (CAPS) Consortium [90]

From: Current status of inherited pancreatic cancer

Target population

Peutz-Jeghers syndrome (carriers of a germline LKB1/STK11 gene mutation)

Germline CDKN2A mutation

Germline BRCA2, BRCA1, PALB2, ATM, MLH1, MSH2, or MSH6 gene mutation with at least one affected first-degree blood relative

Individuals who have at least one first-degree relative with PC who in turn also has a first-degree relative with PC (FPC kindred)

The onset of screening

FPC kindred (without a known germline mutation)

Start at age 50 or 55 or 10 years younger than youngest affected blood relative

Mutation carriers: for CDKN2A, Peutz-Jeghers syndrome,

Start at age 40 or 10 years younger than the youngest affected blood relative

Mutation carriers: for BRCA2, ATM, PALB2, BRCA1, MLH1/MSH2

Start at age 45 or 50 or 10 years younger than the youngest affected blood relative

Method of screening

At baseline

MRI/MRCP + EUS + fasting blood glucose and/or HbA1c

Follow-up

Alternate MRI/MRCP and EUS (no consensus if and how to alternate)

Routinely test fasting blood glucose and/or HbA1c

On indication

Serum CA 19–9

If suspected features on imaging

EUS-FNA only

Solid lesions of ≥5 mm

Cystic lesions with suspected features

Asymptomatic MPD strictures (regardless of tumor presence)

CT only

Solid lesions, regardless of size

Asymptomatic MPD strictures of unknown etiology (without tumor)

Intervals

12 months

If no abnormalities, or only non-concerning abnormalities (e.g., pancreatic cysts without suspected features)

3 or 6 months

If suspected abnormalities for which immediate surgery is not indicated

  1. Abbreviations
  2. CA19–9 Carbohydrate antigen 19–9
  3. CT Computer tomography
  4. EUS Endoscopic ultrasound
  5. FNA Fine-needle aspiration
  6. FPC Familial pancreatic cancer
  7. MPD Main pancreatic duct
  8. MRCP Magnetic resonance cholangiopancreatography
  9. MRI Magnetic resonance imaging
  10. PC Pancreatic cancer