Prospective Screening for Pancreatic Ductal Adenocarcinoma in High-Risk Individuals

Inclusion Criteria

Participants must meet any of the following:

• Individuals with pathogenic/likely pathogenic germline variants in STK11, and age ≥30 years.
• Individuals with pathogenic/likely pathogenic germline variants in CDKN2A, and age ≥40 years (or 10 years younger than the earliest exocrine pancreatic cancer diagnosis in the family, whichever is earlier).
• Individuals with pathogenic/likely pathogenic germline variants in one of the other pancreatic cancer susceptibility genes (ATM, BRCA1, BRCA2, MLH1, MSH2, MSH6, EPCAM, PALB2, TP53), and age ≥50 years (or 10 years younger than the earliest exocrine pancreatic cancer diagnosis in the family, whichever is earlier) AND

• Exocrine pancreatic cancer in ≥1 first- or second-degree relative from the same side of (or presumed to be from the same side of) the family as the identified pathogenic/likely pathogenic germline variant.
• Individuals with pathogenic/likely pathogenic variants in PRSS1 AND a clinical phenotype consistent with hereditary pancreatitis, and age ≥40 years (or 20 years after onset of pancreatitis, whichever is earlier).
• Individuals with familial pancreatic cancer including:

• Family history of exocrine pancreatic cancer in ≥2 first-degree relatives from the same side of the family, even in the absence of a known pathogenic/likely pathogenic germline variant, OR
• Family history of exocrine pancreatic cancer in 1 affected first-degree relative and 1 second-degree relative, even in the absence of a known pathogenic/likely pathogenic germline variant, OR
• Family history of exocrine pancreatic cancer in ≥3 first- and/or second-degree relatives from the same side of the family, even in the absence of a known pathogenic/likely pathogenic germline variant.
• Individuals who are undergoing clinically recommended pancreatic cancer surveillance.

Exclusion Criteria

• Individuals with active or prior pancreatic ductal adenocarcinoma diagnosis.
• Individuals with any active metastatic cancer.
• Individuals who are unable to give informed consent.
• Individuals who are under the age of 18 (infants, children, teenagers).
• Individuals unable to tolerate Magnetic Resonance Imaging/Magnetic Resonance Cholangiopancreatography and Endoscopic Ultrasound.
• Pregnant women are unlikely to be undergoing screening procedures and will not be considered eligible but can consent to the study at a later date.