Pancreatic Cancer and the Family Connection - The Role of Advanced Practitioners in Screening and Educating Genetically At-Risk Individuals

Sep 24, 2026

Uploaded by Noah

Pancreatic cancer is highlighted as a highly lethal malignancy with a 95% mortality rate within five years after initial diagnosis, and pancreatic ductal adenocarcinoma as the most common histotype. Familial pancreatic cancer is linked to pathogenic variants in susceptibility genes, making family history a primary screening tool. For genetically at-risk individuals, advanced screening modalities such as endoscopic ultrasonography, magnetic resonance imaging, and magnetic resonance cholangiopancreatography are reviewed to support early detection and improved survivability.

LanguageEnglish

CategoryHealthcare

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Pages7

Reading Time18 min

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Abstract

Familial risk and genetic predisposition

Screening tools for at-risk individuals

Goals and rationale for early identification

This article is distributed under the terms of the Creative Commons Attr ibution Non-Commercial Non-Derivative License, which permits unrestricted non- -commercial and non derivative use, distribution, and reproduction in any medium, provided the original work is properly c ited . Pancreatic Cancer and the Family Connection: The Role of Advanced Practitioners in Screening and Educating Genetically At-Risk Individuals TRACY LOWE,1 PhD, MS, RN, JANE DELUCA,1 PhD, MS, RN, CPNP-PC, LUDOVICO ABENAVOLI,2 MD, PhD, MSc, and LUIGI BOCCUTO,1 MD From 1School of Nursing, Clemson University, Clemson, South Carolina, USA; 2Department of Health Sciences, University Magna Graecia, Catanzaro, Italy Authors’ disclosures of conflicts of interest are found at the end of this article. Correspondence to: Tracy Lowe, PhD, MS, RN, 421 CU Nursing Building, 605 Grove Rd, Greenville, SC 29605 E-mail: [tbrock@clemson.edu](tbrock@clemson.edu) [https://doi.org/10.6004/jadpro.2023.14.6.6](https://doi.org/10.6004/jadpro.2023.14.6.6)[ ](https://doi.org/10.6004/jadpro.2023.14.6.6)© 2023 BroadcastMed LLC J Adv Pract Oncol 2023;14(6):533–539 Abstract Pancreatic cancer is the third leading cause of cancer deaths in the United States. It has a 95% mortality rate within 5 years of the initial diagnosis. Pancreatic ductal adenocarcinoma is the most commonly diagnosed histotype. The average age at diagnosis is 70 years. Familial forms of pancreatic cancer have been associated with pathogenic variants in predisposing genes, including ATM, BRCA1, BRCA2, PALB2, CDKN2A, STK11, MLH1, and MSH2 . Collecting information on the patient’s family history may serve as a primary tool to screen an individual’s risk for familial pancreatic cancer. More advanced screening options for individuals at risk include endoscopic ultrasonography, magnetic resonance imaging, and magnetic resonance cholangiopancreatography. Due to pancreatic cancer’s high mortality rate, routine screening of individuals at risk for developing familial pancreatic cancer may result in early diagnosis and improved survivability. This review aims to characterize the genetic risk factors associated with pancreatic cancer and recognize available screening options for at-risk individuals. P ancreatic cancer is oneof the deadliest cancersin the United States, accounting for 8% of cancer deaths each year. It is surpassed only by lung cancer (23%) and colorectal cancer (9%) in terms of causes of cancer deaths annually (Centers for Disease Control and Prevention [CDC], 2022). Pancreatic cancer af- fects approximately 89,234 individuals annually, with an estimated mortality rate of 95% within 5 years of diagnosis (National Cancer Institute, 2023; Underhill et al., 2015). The most common type of pancreatic cancer is pancreatic ductaladenocarcinoma (PDAC; Yurgelunet al., 2018), which accounts for almost 90% of all cases (Orth et al., 2019) . Pancreatic ductal adenocarcinoma develops in the exocrine regions of the pancreas, with the majority of tumors (approximately 65%) developing in the head of the pancreas (Sarantiset al., 2020) . Histopathologic classification of pancreatic cancer is determined by microscopic exam (Collisson et al., 2019) . Other rare types of exocrine pancreatic cancers account for less than 10% of pancreatic cases. These include acinar cell carcinoma (ACC), which can produce excess lipase, and mucinous cystic neoplasm (MCN) with an invasive form of adenocarcinoma. Mucinous cystic neoplasm with invasive adenocarcinoma presents as a fluid-filled cyst usually on the tail of the pancreas. A different type of pancreatic cancer is the slow-growing pancreatic neuroendocrine tumors (NETs). These arise from the endocrine tissues of the pancreas, and they are categorized based on the hormone they produce. Pancreatic NETs can produce insulin (most common presentation), glucagon, gastrin, somatostatin, vasoactive intestinal peptide, and adrenocorticotropic hormone (American Cance

FAQs

Why is family history important for screening familial pancreatic cancer risk?

Familial forms are associated with pathogenic variants in susceptibility genes, so collecting patient family history helps identify an individual’s risk for familial pancreatic cancer early.

What screening methods are discussed for genetically at-risk individuals?

The review discusses endoscopic ultrasonography, magnetic resonance imaging, and magnetic resonance cholangiopancreatography as more advanced options for people at risk.

What is the primary goal of screening at-risk individuals?

The primary aim is to reduce mortality by enabling early identification of precancerous lesions.

Sep 24, 2026

Uploaded by Noah