Key Points
➤ All patients diagnosed with pancreatic adenocarcinoma should undergo
assessment of risk for hereditary syndromes known to be associated with an
increased risk for pancreatic adenocarcinoma.
• Assessment of risk should include a comprehensive review of family history of cancer.
Assessment
➤ PCO 1.1 Clinical evaluations of people (with or without pancreatic cancer)
should include assessment for possible genetic predisposition syndromes,
beginning with a review of family history of cancer (including tumor types and
ages at diagnosis for all first and second-degree relatives). (Strong Statement;
IC-B)
➤ PCO 1.2 Individuals with a family history of pancreatic cancer affecting two 1st
degree relatives meet criteria for familial pancreatic cancer. (Strong Statement;
IC-B)
• Individuals whose family history meets criteria for familial pancreatic cancer, those with
3 or more diagnoses of pancreatic cancer in same side of the family, and individuals
meeting criteria for other genetic syndromes (Table 1) associated with increased risk
for pancreatic cancer have an increased risk for pancreatic cancer and are candidates for
genetic testing.
Qualifying Statement. It is important to note that for 90% of families meeting criteria for
familial pancreatic cancer, genetic testing does not detect a pathogenic mutation, therefore
there may be additional shared epigenetic, genetic, or environmental factors that contribute to
pancreatic cancer risk.
➤ PCO 1.3 Genetic risk evaluation should be conducted in conjunction with health
care providers familiar with the diagnosis and management of hereditary cancer
syndromes to determine the most appropriate testing strategy and discuss
implications of the findings for family members. (Strong Statement; IC-B)
• Germline genetic testing for patients with pancreatic cancer should be offered in the
context of shared decision making.
