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HP Screening

 

Why do we screen for Pancreatic Cancer?

The best chance of long term cure from pancreatic cancer is through early diagnosis. However there is no single test which can detect every emerging cancer. Screening for pancreatic cancer is particularly challenging and there is currently no proven programme for the surveillance of individuals estimated to be an increased risk of developing this cancer.

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Entry criteria

  • Any member of a HP family who has been confirmed to carry a causative PRSS1 mutation.
  • An affected member of a family consistent with HP which has tested negative for known causative PRSS1 mutations.

Screening usually takes place from the age of 40.

 

What is being tested?

None of the blood tests or imaging techniques are ideal. The aim is to see what combination of tests gives the best chance of picking up an early cancer and the least chance of missing one. The methods that can be taken up include:

  • Blood tests: Fasting Glucose and CA19-9.
  • Imaging: Endoluminal Ultrasound (EUS) and Computed Tomography (CT).
  • Molecular methods: Endoscopic Retrograde Cholangio-Pancreatography (ERCP) to allow molecular analysis of pancreatic juice. We are currently developing another method for obtaining pancreatic juice using Oesophago-gastro duodenoscopy (OGD), which we hope will be ready soon. This will allow molecular analysis of pancreatic juice.

Fasting glucose

A simple blood test to check sugar level in your blood. It increases if you become diabetic.

 

CA19-9

A marker that can be detected in your blood. It may increase if a pancreatic cancer is present, but also may not. It can become raised when there is no cancer present, particularly in individuals with chronic pancreatitis, so is an incomplete test.

EUS

A telescope test where a camera is inserted through your mouth and down your gullet into your stomach. Once inside the stomach, ultrasound images of your pancreas are obtained. As the organs are so close a very high definition picture can be obtained.

CT

A scan that combines conventional X-ray technology and a computer to build up a three dimensional image of your insides.

ERCP

Similar to an EUS but the scope is passed a little further and a small plastic tube is used to take juice from the site where your pancreas drains into your small intestine. Changes in your pancreatic juice DNA (the genetic material that has come from the cells in your pancreas) could signify a possible early tumour that cannot be seen on imaging investigations. These DNA changes (if found) will have arisen during your lifetime and will not be the sort of DNA changes that can be passed on to your children.

 

If the investigations suggested a possible problem, then your case would be discussed at a special meeting of pancreatic experts to decide on a plan of treatment. They may recommend continued surveillance, further tests to clarify the findings or evan an operation if a growth were present that could be removed.

 

HP Screening

User: SaraHarrison

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