title: Short-term Results of a Magnetic Resonance Imaging-Based Swedish Screening Program for Individuals at Risk for Pancreatic Cancer.
abstract: OBJECTIVE
  Pancreatic cancer is the fourth leading cause of cancer-related death in Western countries. In approximately 10% of all patients with pancreatic cancer, it is possible to define a positive family history for pancreatic cancer or for one of the other related genetic syndromes. A screening program for individuals at risk is recommended; however, surveillance modalities have not been defined yet.
  
  
  OBJECTIVE
  To analyze the short-term results of a prospective clinical surveillance program for individuals at risk for pancreatic cancer using a noninvasive magnetic resonance imaging (MRI)-based screening protocol.
  
  
  METHODS
  A prospective observational study of all patients with a genetic risk for developing pancreatic cancer who were referred to Karolinska University Hospital between January 1, 2010, and January 31, 2013, using an MRI-based surveillance program. All patients were investigated for the most common genetic mutations associated with pancreatic cancer.
  
  
  METHODS
  A noninvasive MRI-based screening protocol.
  
  
  METHODS
  The ability of MRI to identify potential precancerous or early cancers in individuals at risk for pancreatic cancer.
  
  
  RESULTS
  Forty patients (24 women and 16 men) were enrolled. The mean age was 49.9 years. The mean length of follow-up was 12.9 months. The numbers of relatives affected by pancreatic cancer were 5 in 2 patients (5%), 4 in 5 patients (12.5%), 3 in 17 patients (42.5%), 2 in 14 patients (35%), and 1 in 2 patients (5%). In 4 patients (10%), a p16 mutation was found; in 3, a BRCA2 mutation (7.5%); and in 1, a BRCA1 mutation (2.5%). In 16 patients (40%), MRI revealed a pancreatic lesion: intraductal papillary mucinous neoplasia (14 patients, 35%) and pancreatic ductal adenocarcinoma (2 patients, 5%). One patient had a synchronous intraductal papillary mucinous neoplasia and pancreatic ductal adenocarcinoma. Five patients (12.5%) required surgery (3 for pancreatic ductal adenocarcinoma and 2 for intraductal papillary mucinous neoplasia), while the remaining 35 are under continued surveillance.
  
  
  CONCLUSIONS
  During a median follow-up of approximately 1 year, pancreatic lesions were detected in 40% of the patients, of whom 5 underwent surgery. Although the study time was relatively short, the surveillance program in individuals at risk seems to be effective.
authors: Division of Surgery, Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.
authors: Marco
authors: M
authors: Del Chiaro
authors: Division of Pathology, Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden.
authors: Caroline S
authors: CS
authors: Verbeke
authors: Division of Radiology, Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.
authors: Nikolaos
authors: N
authors: Kartalis
authors: Division of Radiology, Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.
authors: Raffaella
authors: R
authors: Pozzi Mucelli
authors: Department of Clinical Genetics, Karolinska Institute, Stockholm, Sweden.
authors: Peter
authors: P
authors: Gustafsson
authors: Department of Onco-Pathology, Karolinska Institute, Stockholm, Sweden.
authors: Johan
authors: J
authors: Hansson
authors: Department of Medicine, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden.
authors: Stephan L
authors: SL
authors: Haas
authors: Division of Surgery, Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.
authors: Ralf
authors: R
authors: Segersvärd
authors: Division of Surgery, Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.
authors: Åke
authors: Å
authors: Andren-Sandberg
authors: Division of Surgery, Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.
authors: J-Matthias
authors: JM
authors: Löhr
mesh_terms: D000328:Adult; D000368:Aged; D001430:Bacteriocins; D021441:Carcinoma, Pancreatic Ductal / Q000235:genetics / Q000517:prevention & control; D055088:Early Detection of Cancer / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D019398:Genes, BRCA1 / Q000502:physiology; D024522:Genes, BRCA2 / Q000502:physiology; D020022:Genetic Predisposition to Disease; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000235:genetics / Q000517:prevention & control* / Q000601:surgery; D010455:Peptides; D011230:Precancerous Conditions / Q000175:diagnosis; D011446:Prospective Studies; D013548:Sweden
chemical_list: D001430:Bacteriocins; D010455:Peptides; C110490:mutacin II prepeptide, bacteria