Pancreatic Cancer Screening Trial

The Australian pancreatic cancer screening trial is recruiting at St Vincent’s Hospital, Sydney and Austin Health, Melbourne. We are working closely with doctors in Brisbane and Perth and hope to open additional screening sites in the near future. The aim of the study is to assess endoscopic ultrasound (EUS) as a screening method in a population considered to be at increased risk of developing pancreatic cancer.

Why screen for pancreatic cancer?

Early detection and treatment of pancreatic cancer can significantly improve patient outcomes. However, due to the relatively low incidence of pancreas cancer, population-based screening is not considered feasible. Many international screening programs are working together to define a population who may benefit from regular surveillance and to establish evidence-based screening protocols for families at an increased risk of pancreatic cancer.

Pancreatic cancer screening in Australia

The pancreatic cancer screening trial commenced at St Vincent’s Hospital, Sydney, in 2011 and over 150 participants are receiving regular research-based surveillance. The trial has since expanded to Austin Health in Melbourne. The specialist gastroenterologists use endoscopic ultrasound (EUS), a combination of endoscopy and ultrasound, to closely assess the pancreas. The aim of the trial is to determine how effectively EUS detects premalignant lesions and early pancreatic cancers in high risk individuals.

We recently published two peer-reviewed journal articles detailing the St Vincent’s Hospital screening cohort experience. Additional articles in collaboration with Austin Health are in preparation.

 

  1. Dwarte, T et al. (2019) Genetic counselling and personalised risk assessment in the Australian pancreatic cancer screening program. Hereditary Cancer In Clinical Practice 17:30 //doi.org/10.1186/s13053-019-0129-1
  2. O’Neill, RS et al. (2020) Long-term positive psychological outcomes in an Australian pancreatic cancer screening program. Familial Cancer 19(1):23-35 //doi.org/10.1007/s10689-019-00147-3

Who is eligible for screening?

Family history of pancreatic cancer and genetic testing results are the main predictors used to assess individuals eligible for the screening trial.

You may be eligible to join the St Vincent’s Hospital, Sydney, screening study if you are aged 50-80 years* (or 10 years younger than the youngest relative diagnosed with pancreatic cancer) and fit into one of the following inclusion criteria:
• People with two first-degree relatives affected by pancreatic cancer on the same side of the family (e.g. a parent and a sibling, 2 siblings)
• People with three or more relatives affected by pancreatic cancer on the same side of the family, and a first-degree relationship with at least one affected relative
• People who have a faulty BRCA2 or PALB2 gene and have a first-degree relative with pancreatic cancer
• People with Lynch syndrome and have a first-degree relative with pancreatic cancer
• People with Familial atypical multiple mole melanoma syndrome and have a first-degree relative with pancreatic cancer
• People with Peutz-Jeghers syndrome (*screening from age 30)
• People with Hereditary Pancreatitis (*screening from age 40)

What does the study involve?

The main components of the study include:
• Signed consent and completion of a questionnaire on personal health and family history
• Attending a genetic counselling session at a local Family Cancer Clinic
• Endoscopic ultrasounds, at intervals recommended by the study gastroenterologist
• Brief follow up questionnaires at one month, one year and five-year intervals following your first EUS
You will be guided through the process by the site clinical coordinator, who will assist with any questions or concerns along the way.

How do I become involved?

The best way to find out if you are eligible for the study is to gather information about your family history and contact the screening trial coordinator. Information that will be required includes:

• Which of your relatives have had pancreatic cancer, including their name(s), date of birth, age at diagnosis and/or age at death, where they were diagnosed or treated.
• Which of your relatives have had other types of cancer (e.g. breast, bowel etc.), including their name(s), age at diagnosis and/or age at death, where they were diagnosed or treated.
• Details of any genetic testing in the family that has found a faulty copy of one of the cancer predisposition genes or syndromes listed above.

Additional information may be required to confirm the details of pancreatic cancer in relatives (e.g. medical records, death certificates). The screening trial coordinator can provide further information that can help you to obtain this information.

The screening trial coordinator for St Vincent’s Hospital is Tanya Dwarte, who can be contacted using the email: t.dwarte@garvan.org.au.

Victorian individuals wanting to find out more about the Austin Health eligibility and the enrolment process can email the screening trial coordinator on info@pancare.org.au.

Further reading:

Goggins, M et al. Management of patients with increased risk for familial pancreatic cancer: updated recommendations from the International Cancer of the Pancreas Screening (CAPS) Consortium (2020) Gut 69(1):7-17. //doi.org/10.1136/gutjnl-2019-319352

 

APGI