AsianScientist (Oct. 20, 2014) – Pancreatic cancer likely takes between 10 and 20 years to develop, providing the potential for a very “broad window” of intervention if detected early in people who inherit a predisposition, say Australian clinical researchers.
In a paper published online in Cancer, the authors suggest that it should now be possible to identify novel susceptibility genes and at the same time design risk management and screening programs for the genetically susceptible group.
Pancreatic cancer is a lethal disease with a five-year survival rate of less than five percent. Most patients cannot be saved because diagnosis comes only after the disease is advanced or has spread. Long-term survivors are those who have small tumours which can be totally removed, and whose lymph nodes are clear of disease.
The greatest known risk factors are cigarette smoking and a family history of the disease. Other risk factors include diabetes and obesity and, to a lesser extent, alcohol consumption.
Dr. Jeremy Humphris and Professor Andrew Biankin, from Sydney’s Garvan Institute of Medical Research, analysed medical histories and tumor samples taken from a cohort of 766 pancreatic cancer patients, operated on between 1994 and 2012. Roughly nine percent of these patients had a first-degree relative (parent or sibling) with pancreatic cancer, a figure consistent with other studies.
Patients with close relatives were shown to be more far more likely to have at least one other form of cancer, as were relatives. In 71 percent of affected parent-child pairs, the child was around 12 years younger at diagnosis, which may reflect an inheritance phenomenon known as ‘anticipation’. Active smokers were ten years younger than the norm at diagnosis, as opposed to five years younger in patients who had not inherited the disease.
“Our findings suggest that when we’re assessing someone, it’s important to understand the family history—not just of pancreatic cancer, but other malignancies too,” said Dr. Humphris. “Smoking led to a much earlier onset of disease, so obviously you would counsel against smoking, especially in those who are genetically susceptible.”
Prof. Biankin concurred, observing that “a better understanding of the clinical features of genetically at-risk individuals will help us identify susceptibility genes as well as those who might benefit from genetic counseling and screening for detection of early disease.”
The article can be found at: Humphris et al. (2014) Clinical and Pathologic Features of Familial Pancreatic Cancer.
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Source: Garvan Institute.
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