J Dig Cancer Res.  2024 Aug;12(2):102-105. 10.52927/jdcr.2024.12.2.102.

Tailored Surveillance Strategies for Pancreatic Cancer in Patients with Chronic Pancreatitis

• Shin H
• Choe JW

• KMID: 2559187
• DOI: http://doi.org/10.52927/jdcr.2024.12.2.102

Abstract

Chronic pancreatitis, a significant risk factor for pancreatic cancer, necessitates monitoring for pancreatic cancer development. Chronic pancreatitis can be broadly categorized into hereditary and sporadic. Given the variability in the risk for pancreatic cancer based on the presence and type of genetic mutations, it is crucial to establish and be aware of guidelines for screening and surveillance tailored to each risk level. In cases of hereditary chronic pancreatitis with PRSS1 mutations, patients demonstrated a high incidence of pancreatic cancer, justifying the rationale for screening and surveillance. However, the incidence of pancreatic cancer is relatively low in hereditary chronic pancreatitis with other genetic mutations and sporadic chronic pancreatitis; thus, precise screening and periodic surveillance are not recommended. For individuals with PRSS1 mutation-related hereditary chronic pancreatitis, surveillance may be considered from the age of 40 years. While computed tomography or magnetic resonance imaging is suitable for pancreatic cancer screening, endoscopic ultrasonography is not recommended because of parenchymal inflammation, fibrosis, and calcification. However, in cases of sporadic chronic pancreatitis where various risk factors for pancreatic cancer coexist, the incidence of pancreatic cancer significantly increases. Therefore, in 5 years after the diagnosis of chronic pancreatitis, the pancreatic cancer incidence has been observed to continuously increase. In such cases, individualized screening tests and surveillance based on the patient’s symptoms and specific circumstances must be considered.

Keyword

Chronic pancreatitis; Pancreatic neoplasms; Hereditary pancreatitis; Population surveillance