Characteristics and Clinical Outcomes of Individuals at High Risk for Pancreatic Cancer: A Descriptive Analysis from a Comprehensive Cancer Center
Abstract
:1. Introduction
1.1. Risk Factors for PC
1.2. Pre-Malignant PC Precursors Exist and Can Be Detected via Imaging
2. Results
2.1. Characteristics of the Study Cohort
2.2. Outcomes of HRI that met CAPS Guidelines
2.3. Outcomes of HRI That Did Not Meet CAPS Guidelines
2.4. Outcomes of Sporadic Cases
3. Discussion
4. Methods
Supplementary Materials
Author Contributions
Acknowledgments
Conflicts of Interest
References
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Syndrome | Gene(s) | Risk of PC by Age 70–75 | Studies Reporting PC Precursor Lesions * among Carriers |
---|---|---|---|
Hereditary Breast and Ovarian Cancer (HBOC) | BRCA2 | 4.5–8% | [23] |
BRCA1, PALB2 | 3.6% | ||
Peutz-Jeghers (PJS) | STK11/LKB1 | 36% | [24] |
Familial atypical multiple-mole melanoma (FAMMM) | P16/CDKN2A | 13–17% | [25] |
Hereditary non-polyposis colorectal cancer (HNPCC) | MSH2, MLH1, MSH6, PMS1, PMS2 | 3.7% | [23,26,27] |
Familial adenomatous polyposis (FAP) | APC | 1.7% | [28] |
Ataxia telangiectasia | ATM | <5% | None identified |
Li Fraumeni | TP53 | <5% | [29] |
Hereditary Pancreatitis | PRSS1, SPINK1 | 25–54% | [30] |
Cystic Fibrosis | CFTR | <5% | [31] |
Characteristic | Entire Cohort | High Risk According to CAPS Guidelines (n = 105) | Increased risk that Does Not Meet CAPS Guidelines (n = 158) | Sporadic Cases (n = 66) | p * |
---|---|---|---|---|---|
Sex | |||||
Male | 86 (26.1) | 33 (31.4) | 21 (13.3) | 32 (48.5) | <0.0001 |
Female | 243 (73.9) | 72 (68.6) | 137 (86.7) | 34 (51.5) | |
Race/ethnicity | |||||
Non-Hispanic White | 277 (84.5) | 93 (88.5) | 127 (80.9) | 57 (86.4) | 0.86 |
Non-Hispanic Black | 18 (5.5) | 5 (4.8) | 10 (6.4) | 3 (4.5) | |
Hispanic White | 22 (6.7) | 5 (4.8) | 13 (8.3) | 4 (6.1) | |
Other | 11 (3.3) | 2 (1.9) | 7(4.4) | 2 (3.0) | |
Missing | 1 | 0 | 0 | 1 | |
Smoking Status | |||||
Current | 27 (8.2) | 9 (8.9) | 14 (10.2) | 4 (6.3) | 0.06 |
Former | 192 (58.4) | 23 (22.8) | 33 (23.9) | 27 (42.9) | |
Never | 83 (25.2) | 69 (68.3) | 91 (65.9) | 32 (50.8) | |
Missing | 27 | 4 | 20 | 3 | |
Personal History of Cancer or Other Conditions | |||||
Breast Cancer | 10 (3.1) | 5 (4.8) | 2 (1.3) | 3 (4.5) | € |
Colorectal cancer | 3 (0.9) | 0 (0.0) | 1(0.6) | 2 93.0) | |
¥ Gynecological Cancer | 3 (0.9) | 1 (1.0) | 0 (0.0) | 2 (3.0) | |
Prostate Cancer | 10 (3.1) | 2 (1.9) | 0 (0.0) | 8 (12.1) | |
¥ Other cancer | 13 (4.0) | 1 (1.0) | 2 (1.3) | 10 (15.2) | |
Pancreatitis | 9 (2.8) | 2 (1.9) | 2 (1.3) | 5 (7.6) | |
Diabetes | 9 (2.8) | 1 (1.0) | 1 (0.6) | 7 (10.6) | |
None | 270 (82.6) | 92 (88.5) | 149 (94.9) | 29 (43.9) | |
Missing | 2 | 1 | 1 | 0 | |
Pancreatic lesion detected on imaging | |||||
Had imaging and a lesion was detected | 107 (32.5) | 31 (29.5) | 10 (6.3) | 66 (100.0) | <0.0001 |
Had imaging and no lesion was detected | 65 (19.8) | 52 (49.5) | 13 (8.2) | 0 (0.0) | |
No imaging on file | 157 (47.7) | 22 (21.0) | 135 (85.4) | 0 (0.0) | |
Type of pancreatic lesion detected | <0.001 † | ||||
Cyst, type not specified | 49 (14.9) | 20 (19.1) | 2 (1.3) | 27 (40.9) | |
Intraductal papillary mucinous neoplasm | 51 (15.5) | 9 (8.6) | 8 (5.1) | 34 (51.5) | |
Mucinous cystic neoplasm | 1 (0.3) | 0 (0.0)) | 0 (0.0) | 1 (1.5) | |
Pseudocyst | 2 (0.6) | 0 (0.0) | 0 (0.0) | 2 (3.0) | |
Solid Tumor/Adenocarcinoma | 3 (0.9) | 2 (1.9) | 0 (0.0) | 1 (1.5) | |
Pancreatic Neuroendocrine Tumor | 1 (0.3) | 0 (0.0) | 0 (0.0) | 1 (1.5) | |
Average age at diagnosis of pancreatic lesion | 65.5 | 62.6 | 60.7 | 67.6 | <0.020 |
Average size of largest lesion detected (cm) | 2 | 0.7 | 2 | 2.6 | <0.0001 |
Body Mass Index (BMI) | - | 28.3 | 30.3 | 27 | 0.27 |
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McNamara, G.P.J.; Ali, K.N.; Vyas, S.; Huynh, T.; Nyland, M.; Almanza, D.; Laronga, C.; Klapman, J.; Permuth, J.B. Characteristics and Clinical Outcomes of Individuals at High Risk for Pancreatic Cancer: A Descriptive Analysis from a Comprehensive Cancer Center. Gastrointest. Disord. 2019, 1, 106-119. https://doi.org/10.3390/gidisord1010008
McNamara GPJ, Ali KN, Vyas S, Huynh T, Nyland M, Almanza D, Laronga C, Klapman J, Permuth JB. Characteristics and Clinical Outcomes of Individuals at High Risk for Pancreatic Cancer: A Descriptive Analysis from a Comprehensive Cancer Center. Gastrointestinal Disorders. 2019; 1(1):106-119. https://doi.org/10.3390/gidisord1010008
Chicago/Turabian StyleMcNamara, Griffin P. J., Karla N. Ali, Shraddha Vyas, Tri Huynh, Monica Nyland, Deanna Almanza, Christine Laronga, Jason Klapman, and Jennifer B. Permuth. 2019. "Characteristics and Clinical Outcomes of Individuals at High Risk for Pancreatic Cancer: A Descriptive Analysis from a Comprehensive Cancer Center" Gastrointestinal Disorders 1, no. 1: 106-119. https://doi.org/10.3390/gidisord1010008