Most pancreatic cancers happen by chance and don't run in families. So, if only one close relative has had pancreatic cancer it is unlikely that cancer of the pancreas runs in your family. However, up to 10 out of every 100 cases (10%) of cancer of the pancreas  might be due to inheriting a faulty gene

There are a number of different gene changes that can increase your risk of developing cancer of the pancreas. These include:

• BRCA2 also linked to breast, ovarian and prostate cancer
• HNPCC which is more commonly linked to bowel cancer
• FAP also linked to bowel cancers
• familial atypical mole melanoma (FAMMM) also linked to malignant melanoma
• hereditary pancreatitis
• Peutz-Jeghers syndrome also causes benign growths (polpys) in the stomach and intestines.

Some families don't have any of these medical conditions but have at least two first degree relatives affected by pancreatic cancer. (A first degree relative is a father, mother, son, daughter, brother or sister.) These families may have familial pancreatic cancer. We don't know which gene or genes are linked to familial pancreatic cancer. So, it isn't possible to do a genetic test to find out if other members of the family are at increased risk or not.

It is recommended that if your family may have an increased risk of pancreatic cancer you are referred to a specialist cancer genetics centre, where you will be counselled about your personal risk and offered the chance to take part in screening.

The aim of screening is to try to detect pancreatic cancer early, if it occurs. It isn't clear how effective screening for pancreatic cancer is or which tests should be used. So you may be offered screening as part of a clinical trial.

In the UK, the national co-ordinating centre for screening for people at high risk of pancreatic cancer is the European Registry for Familial Pancreatic Cancer and Hereditary Pancreatitis (EUROPAC).

EUROPAC run a screening programme for people over 30 years of age with a strong family history of cancer of the pancreas and for people with hereditary pancreatitis who are over 40 years old.

The screening involves scans and possibly a test called an endoscopic retrograde cholangio-pancreatography (ERCP). These tests are repeated every 1-3 years.

EUROPAC are also currently running a study to try to find out which genes cause familial pancreatic cancer. If you take part in this study it involves filling out a questionnaire, having blood samples taken and your name put on a register.

If you have a family history of cancer of the pancreas and would like to know more you can contact EUROPAC at the address below or through your GP or hospital doctor.

Contact:

Dr Chris Grocock
EUROPAC Study Co-ordinator/Research fellow in Surgery
Division of Surgery & Oncology
5th Floor UCD Block
Royal Liverpool University Hospital
Daulby Street
Liverpool L69 3GA
United Kingdom

Tel: 0151 706 4168
Fax: 0151 706 5826
Email: europac@liv.ac.uk

Reference

• Pancreatic section of the British Society of Gastroenterology et al. Guidelines for the management of patients with pancreatic cancer periampullary and ampullary carcinomas. Gut 2005;54(SupplV):v1-v16.