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It is a frustrating and emotional issue for patient and doctor alike when an individual with a family history of pancreatic cancer (PC) seeks counselling on how best to prevent or detect this disease at a curable stage. Uniformly, these individuals have had first-hand experience of the death of a relative from PC—often within a period of months. Thus, doctors have a vulnerable patient population who would readily consider therapies ranging from blood tests to invasive procedures and even to prophylactic pancreatectomy.1 Unlike colon or breast cancer, there are no established screening or surveillance PC guidelines to assist practitioners. Due to a paucity of conclusive data, guidelines for individuals at risk for PC do not exist; however, based on opinion and limited study results, recognised experts in PC created practice recommendations for counselling high-risk individuals (HRIs) including potential surveillance and preventive measures.2
In this issue (see page 1410), Langer and colleagues publish the results of a 5-year, prospective screening study of 76 HRIs from 34 of the available 110 familial PC families (mainly defined in their registry as two or more first-degree relatives affected with PC) using the German National Case Collection for Familial Pancreatic Cancer.3 Their surveillance algorithm proposed yearly …
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