406 Risk-Stratified Secondary Surveillance for Individuals in the UK at High Risk of Developing Pancreatic Cancer: Outcomes from the European Registry of Hereditary Pancreatic Diseases (EUROPAC)
Year: 2025
Type: article
Study design: Observational Study
Abstract: Aim To determine the impact of EUROPAC risk-stratification, which takes account of kinship, family size, age and germline mutations in such predisposed individuals Method Observational study of asymptomatic individuals, prospectively registered with EUROPAC meeting surveillance criteria: endoscopic ultrasound annually with a contrast magnetic resonance image every third year. Results Between January 2000 and April 2025, 900 registered individuals were assessed with 873 being able to take up surveillance, median age of 52 years. 508 individuals (404 pathogenic variant gene mutation negative (PV-ve) and 104 with a PV +ve)) in the 20 years prior to 2020 without stratification were compared to 385 (269 PV -ve and 116 PV +ve) in the 5 years following 2020 who had unique EUROPAC risk-stratification applied. Four (0.8%) individuals had actionable pancreatic findings prior to risk stratification vs. 15 (4%), who underwent risk-stratified surveillance (p=0.001). Operable lesions were found in 3 (0.6%) and 11(3%) p=0.007, respectively with 2 (0.4%) and 9 (2%) being resected, p=0.009. The median (IQR) for time in surveillance prior to a lesion being detected was 4 (2 – 7) years, without significant difference between the groups. Overall, 74% of EUROPAC detected precursor lesions or pancreatic cancers were Conclusions The risk-stratified group was 25% smaller than the non-stratified group but showed significant enrichment for important findings, suggesting the key usefulness of risk stratification in targeting secondary surveillance to individuals who will most likely benefit from it.
Source: British journal of surgery
Authors: Phillip Hopley, Ryan Peysner, Annabelle Boughey, Bharti Kewlani, Andrew Smith, Guru Aithal, Kofi Oppong, Meg Finch-Jones, Zaed Hamady, Tejinderjit Athwal, James Milburn, Shyam Menon, Michael Chapman, Stephen Pereira, Mark Taylor, Guy Shingler, Chistopher Briggs, Paula Ghaneh, Eithne Costello, William Greenhalf, Christopher Halloran
Institutions: University of Liverpool, Liverpool University Hospitals NHS Foundation Trust, Leeds Teaching Hospitals NHS Trust, Nottingham University Hospitals NHS Trust, University of Nottingham, Freeman Hospital, Newcastle University, University Hospitals Bristol and Weston NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, University Hospitals of North Midlands NHS Trust, Aberdeen Royal Infirmary, New Cross Hospital, University College Hospital, University College London Hospitals NHS Foundation Trust, Belfast City Hospital, Morriston Hospital, Derriford Hospital
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7117464655
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