Profile Identifies Patients at Greatest Pancreatic Cancer Risk

A team of physicians at Mayo Clinic have developed a profile they say will allow clinicians to separate patients who are either at high risk or low risk of pancreatic cancer.

The team of researchers sought ways to identify patients at high risk for the disease, which they note is difficult to detect early, with most patients diagnosed at later stages when pancreatic cancer is 95% fatal.
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For this study, the authors evaluated intraductal papillary mucinous neoplasms, lesions which can become cancerous. The team examined data on 1,126 patients diagnosed with lesions in the pancreas. Among this group, just 84 were found to have invasive pancreatic cancer. These patients had all or some of a number of factors that categorized them as high risk, such as a history of smoking and obesity. In addition, the researchers considered jaundice as well as steatorrhea, or fat droplets in the stool indicating the pancreas is not producing an adequate amount of digestive enzyme; both of which are symptoms of pancreatic cancer.

Other risk factors were larger cyst sizes on imaging scans, cysts in the main pancreatic duct, and the presence of nodules on the cyst wall, according to the authors, who note that abdominal pain was not a risk factor in the study, despite typically being considered as much.

There are currently no screening strategies for pancreatic cancer, says Massimo Raimondo, MD, a fellow of gastroenterology at Mayo Clinic in Jacksonville, Fla., and a co-author of the study.

However, he says, “A significant proportion of patients who will develop pancreatic cancer will manifest hyperglycemia or frank type II diabetes, sometimes up to 3 years prior to the diagnosis of pancreatic cancer.”

Therefore, “it is important, from a primary care perspective, to look for blood sugar abnormalities in patients older than 50 with no family history for diabetes,” continues Raimondo. “In that setting, a transabdominal ultrasound—a very inexpensive imaging test—can guide more testing versus observation.”

—Mark McGraw

Reference

Moris M, Raimondo M, et al. Risk factors for malignant progression of intraductal papillary mucinous neoplasms. Digestive and Liver Disease. 2015.