Evaluating Susceptibility to Pancreatic Cancer: ASCO Provisional Clinical Opinion
- Study type
- Clinical guideline
- Study name
- ASCO PCO 2019
- Design
- ASCO Provisional Clinical Opinion based on a systematic review of the literature published from January 1998 to June 2018, developed by an expert panel
- Source
- JCO · 2019
In plain words
This guideline explains who may be more likely to get pancreatic cancer because of family history or inherited conditions. Everyone with pancreatic cancer is advised to be assessed for inherited risk and to have their family history of cancer reviewed. If two first-degree relatives in a family (for example parents, brothers and sisters, or children) have had pancreatic cancer, or three or more people on one side of the family, genetic testing and a talk with the doctor about the benefits and limits of screening can be helpful.
Key guideline recommendations
- ASCO provisional clinical opinion
All patients diagnosed with pancreatic adenocarcinoma should undergo assessment of risk for known hereditary syndromes associated with an increased risk of pancreatic adenocarcinoma. Risk assessment should include a comprehensive review of the family history of cancer.
- ASCO provisional clinical opinion
Individuals with a family history of pancreatic cancer in two first-degree relatives meet the criteria for familial pancreatic cancer (FPC).
- ASCO provisional clinical opinion
Individuals (with or without cancer) whose family history meets FPC criteria, individuals with three or more diagnoses of pancreatic cancer on the same side of the family, and individuals who meet criteria for other genetic syndromes associated with an increased risk of pancreatic cancer are at increased risk and are candidates for genetic testing.
- ASCO provisional clinical opinion
Germline genetic testing for cancer susceptibility may be discussed with individuals diagnosed with pancreatic cancer, even if family history is unremarkable.
- ASCO provisional clinical opinion
The benefits and limitations of pancreatic cancer screening should be discussed with individuals whose family history meets FPC criteria and/or who have a genetic susceptibility to pancreatic cancer.
Study population
Patients with pancreatic adenocarcinoma and their family members in whom an inherited susceptibility to pancreatic adenocarcinoma is suspected.
Endpoints
This document is a clinical guidance document and has no trial endpoint. Its subject is the identification and management of patients and family members who may have a susceptibility to pancreatic adenocarcinoma.
Safety and side effects
No adverse event data are reported in the abstract. The abstract states only that the benefits and limitations of pancreatic cancer screening should be discussed with eligible individuals.
Clinical significance and place in guidelines
According to this ASCO provisional clinical opinion, assessment of the risk of inherited syndromes and a comprehensive review of family history are recommended for all patients with pancreatic adenocarcinoma. Genetic testing is indicated for individuals who meet FPC criteria or the criteria of other relevant genetic syndromes, and for affected individuals it can be discussed even with an unremarkable family history. The current status of these recommendations in updated ASCO and other societies' guidelines should be checked.
Limitations
This document is a "provisional clinical opinion", not a full guideline. The abstract gives no information on the level of evidence, the strength of the recommendations or the number of studies included, and these details should be checked in the full text. The literature search extended to June 2018 and newer evidence may not be included.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.