Is screening available for people with a family history of pancreatic cancer?
Screening aims to find people who will get a disease before they get any signs or symptoms of it. There is no national screening programme for pancreatic cancer for the general population at the moment.
However, if you have a family history of pancreatic cancer, you might be interested in being referred to the EUROPAC secondary screening study. This research study is trying to find out the best way to screen for pancreatic cancer. Every family is considered individually, but you can take part in the screening if you meet the EUROPAC eligibility criteria:
- you have two or more first-degree relatives diagnosed with pancreatic cancer, or three or more relatives with pancreatic cancer – the relatives must all be on the same side of the family
- there is a family cancer syndrome in your family, and at least one family member has had pancreatic cancer – and they have a faulty gene.
Screening usually starts from the age of 40. It sometimes starts earlier if a relative was diagnosed with pancreatic cancer when they were under 50.
Screening can’t stop someone getting pancreatic cancer, but diagnosing cancer at an earlier stage may mean that treatment is more successful.
Screening should be tailored to each person’s risk and circumstances, and is best discussed in a specialist research centre. To take part in the EUROPAC secondary screening study, your family history will be assessed to work out your risk of pancreatic cancer. If you are screened you could be offered:
- a CT (computerised tomography) scan, or sometimes an MRI scan (magnetic resonance imaging)
- an EUS (endoscopic ultrasound)
- a blood test to check for tumour markers (chemical substances produced by cancers that show up in the bloodstream) such as CA19-9
- a blood test to check the level of sugar (glucose) in your blood – this increases if you have diabetes.
If you have hereditary pancreatitis, this can damage the pancreas, which may make the EUS less effective. You may be offered a CT scan every year instead.
If the tests suggest a possible problem, you may be offered continued monitoring or more tests to confirm the findings. You may be offered an operation if a growth is found that could be removed.
Can I have a genetic test for pancreatic cancer?
Genetic tests can look for faults in the genes that we know can be linked to familial pancreatic cancer. If you have a family history of pancreatic cancer, genetic testing may be available. Testing is usually first offered to someone in the family who has developed cancer. If a genetic fault is identified, testing for this fault is then available to relatives who have not developed cancer.
People with familial pancreatic cancer, or another genetic condition linked to an increased risk of pancreatic cancer, should first be offered genetic counselling and then, if appropriate, genetic testing.
Genetic counselling with a genetic counsellor or genetics doctor is used to provide information about an inherited condition and the chance of you developing it or passing it on. It helps to prepare people for what it means if they find out they have a faulty gene that greatly increases their risk of developing pancreatic cancer.
If you are referred to a genetics clinic it’s helpful if you can gather information beforehand including:
- how everyone in the family is related to you and to each other
- how old each affected relative is and their age when they were diagnosed
- what other cancers have been diagnosed in the family.
The specialists can then work out how likely it is that there is a faulty gene in the family. Depending on this risk assessment you may be:
- offered a genetic test if you do have an increased risk and if a test is appropriate
- told you are at increased risk but that genetic testing isn’t appropriate – based on your family history, or because you have no living relative with pancreatic cancer who can be tested first
- told that you aren’t at any more risk than the general population.
If you are offered a genetic test, after you’ve talked to a specialist, it’s up to you to decide whether or not to have it. You can take as much time as you need to decide.
If the test shows that you have a fault in a gene that may cause pancreatic cancer, you can then have screening, as part of a research study.
Published October 2015
Reviewe date October 2017