. Author manuscript; available in PMC: 2013 Jun 3.

Published in final edited form as: Gastroenterol Clin North Am. 2012 Jan 5;41(1):143–157. doi: 10.1016/j.gtc.2011.12.001

Table 1.

Approaches to pancreatic screening

	Sequential Serum Biomarker + Imaging	Sequential Abdominal Imaging Tests	Single or Concurrent Imaging Tests
Sporadic population		Transabdominal US followed by noncontrast MRI/MRCP, prospective study in 2511 patients found 5 cancers (4 resectable)¹³⁰	Transabdominal US in 130,951 patients found 3 PDA¹¹⁷
High-risk population	Serum CA19-9 followed by EUS if >37 U/mL detected in 546 individuals with ≥1 FDR with pancreatic cancer found pancreatic neoplasms in 5/546 (1 early cancer)	MRI/MRCP or CT followed by EUS in FPC relatives found IPMN and PDA in 8.3%¹³⁰ EUS followed by ERCP (when abnormal) detected PanINs⁶⁰	MRI/MRCP only in 79 p16 mutation carriers detected 5 cancers¹²⁵ EUS + MRI/MRCP in FPC relatives detected IPMNs or PDA or both¹³¹ EUS + MDCT in FPC relatives detected IPMNs, PNET, and PDA^115,116 EUS only in FPC relatives and mutation carriers detected IPMNs and PDA¹²⁶

Abbreviations: CA 19-9, carbohydrate antigen 19-9; CT, computed tomography; ERCP, endoscopic retrograde cholangiopancreatography; EUS, endoscopic ultrasound; FDR, first-degree relative; FPC, familial pancreatic cancer; IPMNs, intraductal papillary mucinous neoplasms; MDCT, multi-detector computed tomography; MRI/MRCP, nagnetic resonance imaging/magnetic resonance cholangiopancreatography; PanINs, pancreatic intraepithelial neoplasias; PDA, pancreatic ductal adenocarcinoma; PNET, Pancreatic neuroendocrine tumors; US, ultrasound.