Because pancreatic cancer can be present in multiple hereditary cancer syndromes, it is important to use a gene panel test such as Myriad myRisk™ to identify patients who may be at greatest risk so they can take steps to lower their risk.

Approximately 46,000 new cases of pancreatic cancer are diagnosed in the U.S. each year, some of which are caused by a gene mutation that can be passed from generation to generation.1  Pancreatic cancer can be present in different hereditary cancer syndromes. Because of that, it is important to know your complete family history and evaluate which genetic syndrome is most likely.  When pancreatic cancer is the predominant cancer in a family, the most common known causes are mutations in the PALB2, BRCA2 and p16 genes.

Hereditary Cancer Testing for Pancreatic Cancer

Knowing your potential risk for hereditary pancreatic cancer can help you and your healthcare professional make better, more informed decisions about your health, before the onset of cancer or before a second cancer has had a chance to develop. Genetic testing for hereditary pancreatic cancer with the Myriad myRisk™ Hereditary Cancer test should possibly be considered if:*

  • You have or have had pancreatic cancer and have at least one close relative** with pancreatic cancer.2-7
  • You have a personal or family history of pancreatic cancer and melanoma.
  • You have two or more close relatives** with pancreatic cancer.
  • You are of Ashkenazi Jewish descent and have a personal history of pancreatic cancer or a first-degree relative** with pancreatic cancer.8-10
  • There is a previously identified PALB2, BRCA2 or p16 mutation in your family.11-17

To help you assess whether you may be benefit from hereditary cancer genetic testing, you can take the Myriad Hereditary Cancer Quiz. This quiz can help you get the information you need to discuss your risk of cancer with your healthcare professional and ask for further evaluation.

Using Hereditary Cancer Testing to Reduce Your Risk of Pancreatic Cancer

If the Myriad myRisk Hereditary Cancer test confirms the presence of a PALB2, BRCA2 or p16 mutation, the following medical management options may help reduce cancer risk and may either prevent or delay the onset of pancreatic cancer as well as detect the cancer at an earlier, more treatable stage:

  • Targeted screening and surveillance for pancreatic cancer.
  • Improved compliance with tailored screening recommendations and preventive measures.
  • Improved outcomes through prevention, earlier diagnosis and treatment of specific cancers, including breast, ovarian and melanoma.
  • Counseling for those who carry the mutation and their family members on the underlying cause of the cancer.

*Assessment criteria are based on scientific literature and expert opinion

**Close refers to first- or second-degree relatives. First-degree relatives include parents, siblings, and children. Second-degree relatives include grandparents, aunts/uncles and nieces/nephews.

Any discussion of medical management options is for general informational purposes only and does not constitute a recommendation.  While genetic testing and medical society guidelines provide important and useful information, all medical management decisions should be made based on consultation between each patient and his or her healthcare professional.

References

1. American Cancer Society. Pancreatic Cancer. Available at http://www.cancer.org/cancer/pancreaticcancer/detailedguide/pancreatic-cancer-key-statistics.

2. Jones S, et al. Exomic sequencing identifies PALB2 as a pancreatic cancer susceptibility gene. Science 2009;324(5924):217

3. Slater EP, et al. PALB2 mutations in European familial pancreatic cancer families. Clin Genet 2010;78:490-4

4. Tischkowitz MD, et al. Analysis of the gene coding for the BRCA2-interacting protein PALB2 in familial and sporadic pancreatic cancer. Gastroenterology 2009;137(3):1183-6.

5. Couch FJ, et al. The prevalence of BRCA2 mutations in familial pancreatic cancer. Cancer Epidemiol Biomarkers Prev 2007;16(2):342-6.

6. Hahn SA, et al. BRCA2 germline mutations in familial pancreatic carcinoma. J Natl Cancer Inst 2003;95(3):214-21.

7. Murphy KM, et al. Evaluation of candidate genes MAP2K4, MADH4, ACVR1B and BRCA2 in familial pancreatic cancer: deleterious BRCA2 mutations in 17%. Cancer Res 2002;62(13):3789-93.

8. Ozcelik H, et al. Germline BRCA2 6174delT mutations in Ashkenazi Jewish pancreatic cancer patients. Nat Genet 1997;16(1):17-8.

9. Lal G, et al. Inherited predisposition to pancreatic adenocarcinoma: role of family history and germline p16, BRCA1 and BRCA2 mutations. Cancer Res 2000;60(2):409-16.

10. Ferrone CR, et al. BRCA Germline mutations in Jewish patients with pancreatic adenocarcinoma. J Clin Oncol 2009;27(3):433-8.

11. U.S. Preventive Services Task Force (USPSTF). Genetic risk assessment and BRCA mutation testing for breast and ovarian cancer susceptibility. Ann Intern Med 2005;143(5):355-61. Available at: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrgen.htm

12. American Society of Breast Surgeons Official Statement, BRCA Genetic Testing for Patients With and Without Breast Cancer, 2006. Available at: http://www.breastsurgeons.org/statements/index.php

13. Lancaster JM, et al. Society of Gynecologic Oncologists (SGO) Education Committee Statement on Risk Assessment for Inherited Gynecological Cancer Predispositions. Gynecol Oncol 2007;107(2):159-62. Available at: http://www.sgo.org/WorkArea/showcontent.aspx?id=882

14. American College of Medical Genetics Foundation. Genetic Susceptibility to Breast and Ovarian Cancer: Assessment, counseling, and testing guidelines. 1999 (copyright is 2005). Available at: http://www.ncbi.nlm.nih.gov/books/NBK56955/

15. American College of Obstetricians and Gynecologists Committee on Practice Bulletins. Hereditary breast and ovarian cancer syndrome. Gynecol Oncol 2009;113(1):6-11. Available at: http://www.acog.org/About-ACOG/ACOG-Districts/District-II/Ovarian-Cancer

16. Daly MB, et al. (2010) NCCN Clinical Practice Guidelines in Oncology, Genetic/Familial High-Risk Assessment Breast and Ovarian, V.I.2010. J Natl Compr Canc Netw Available at: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp

17. Bevers TB, et al. (2009) NCCN Clinical Practice Guidelines in Oncology: Breast Cancer Screening and Diagnosis, BSCR-1-3, V.I.2010. J Natl Compr Canc Netw. Available at http://www.nccn.org/professionals/physician_gls/f_guidelines.asp