Expert guidelines for screening for pancreatic cancer in high-risk populations.

This article is based on the expert guidance on pancreatic cancer screening in high risk individuals of NEJM journal watch. Author: Douglas g. Adler, MD, facg, agaf, fasge, what are the screening targets, methods and frequency? In recent years, people have gradually realized the role of genetics in pancreatic cancer.this provides an opportunity for early detection of patients with known genetic risk and improvement of their survival.in the new clinical practice update released by the American Gastroenterological Association, experts put forward practical suggestions on the identification and screening of high-risk groups of pancreatic cancer.the goal of screening was to detect early pancreatic cancer and high-risk precancerous lesions (such as intraductal papillary mucinous tumor and some pancreatic intraepithelial neoplasia).suggestions are as follows.if the patient has more than 2 relatives with pancreatic cancer, pancreatic cancer screening should be considered for their first degree relatives.pancreatic cancer screening should be considered in patients with Boyz jeger syndrome (PJs); patients with hereditary pancreatitis; patients with CDKN2A, BRCA1, BRCA2, PALB2 or ATM gene mutations; or more than one first-degree relative with pancreatic cancer complicated with Lynch syndrome.genetic testing and counseling should be considered for relatives of patients with familial pancreatic cancer.promote high-risk patients to receive treatment in appropriate pancreatic disease treatment centers or register in the registration system.individuals at general risk do not need to be screened for pancreatic cancer.magnetic resonance imaging and endoscopic ultrasonography were used as the main screening methods.the first screening for most high-risk individuals should be 50 years old or 10 years earlier than the onset age of the affected relatives.the first screening for CDKN2A and PRSS1 gene mutations should be at 40 years old, and the first screening for PJs patients should be at 35 years old.when the patient is no longer suitable for pancreatic surgery or has serious complications, it can be considered to stop screening.the authors also stressed that pancreatic cancer screening has not been shown to bring general benefits and that the limitations of such screening should be explained to patients.comments on this document provide useful information and guidance for clinicians.pancreatic cancer screening is still in the experimental stage, and there is no consensus on the screening cycle. Aslanian HR et al. AGA clinical practice update on pancrease cancer screening in high risk individuals: expert review. Gastroenterology 2020 May 13; NEJM journal watch is published by NEJM group. Famous international doctors are invited to comment on important papers in medical field to help doctors understand and apply the latest progress. "NEJM medical frontier" translated several articles every week, published on app and official website, and 2-3 selected articles were published on wechat. copyright information this article is translated, compiled or invited by the editorial department of NEJM medical frontier. for the translation and writing of articles originated from the English products of NEJM group, the original English version shall prevail. the full text of the Chinese translation and the charts included are exclusively authorized by the NEJM group of the Massachusetts Medical Association. for reprint, please contact nejmqianyan@nejmqianyan.cn 。 unauthorized translation is an infringement, and the copyright owner reserves the right to investigate the legal liability.