Familial pancreatic cancer in Italy. Risk assessment, screening programs and clinical approach: A position paper from the Italian Registry

Received 7 April 2010; accepted 22 April 2010. published online 03 June 2010.

Abstract

In Italy, pancreatic cancer is the fifth leading cause of tumor related death with about 7000 new cases per year and a mortality rate of 95%. In a recent prospective epidemiological study on the Italian population, a family history was found in about 10% of patients suffering from a ductal adenocarcinoma of the pancreas (PDAC). A position paper from the Italian Registry for Familial Pancreatic Cancer was made to manage these high-risk individuals. Even though in the majority of high-risk individuals a genetic test to identify familial predisposition is not available, a screening protocol seems to be reasonable for subjects who have a >10-fold greater risk for the development of PDAC. However this kind of screening should be included in clinical trials, performed in centers with high expertise in pancreatic disease, using the least aggressive diagnostic modalities.

Keywords: Family history, Pancreas, Surveillance protocol

a Division of General and Transplant Surgery, Pisa University Hospital, Via Paradisa, 2, 56124 Cisanello, Pisa, Italy

b Pancreatic Surgery Section, Department of Surgery, IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy

c Digestive and Liver Disease Unit, University “La Sapienza”, Rome, Italy

d Department of Pathology, University of Verona, Italy

e European Institute of Oncology, Milan, Italy

f University of Pisa, Department of Biology, Italy

g Division of Gastroenterology and Gastrointestinal Endoscopy, Vita-Salute San Raffaele University, Milan, Italy

h Department of Radiology, University of Bologna, Italy

i Surgical and Gastroenterological Department, University of Verona, Italy

Corresponding author. Tel.: +39 050996926.

PII: S1590-8658(10)00163-5

doi:10.1016/j.dld.2010.04.016

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