Browse by author
Lookup NU author(s): Professor Kofi Oppong
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2026 The Authors.Background Surveillance of individuals with a familial predisposition to pancreatic ductal adenocarcinoma (PDAC) is likely to increase overall survival. Our objective was to determine the impact of EUROPAC risk-stratification (Family Risk, FR), in such predisposed individuals. Methods Observational study of registered asymptomatic individuals undergoing surveillance for PDAC. Individuals without a known pathogenic variant (PV-), ineligible for genetic assessment in the NHS, in whom significant pancreatic lesions were found, were subjected to additional germline testing. Results Between January 2000 and April 2025, 893 individuals started surveillance, median age of 52 years. 508 individuals (404 PV- and 104 with a pathogenic variant (PV+)) in the 20 years prior to 2020 without stratification were compared to 385 (269 PV- and 116 PV+) in the five years from 2020 who had FR risk-stratification applied. Four (0·8 %) individuals had actionable pancreatic findings prior to risk stratification vs. 14 (3·6 %), who underwent risk-stratified surveillance (p = 0·001). Pancreatic lesions deemed operable were found in three (0·6 %) and 11 (3 %), p = 0·007, with two (0·4 %) and nine (2 %) undergoing resection, p = 0·009, respectively. PV- individuals with significant findings were subsequently found to contain mutations, many not in the UK genetics test directory, provided the FR was ' 30. The median (IQR) time in surveillance prior to a lesion being detected was four (2 – 7) years. Overall, 78 % of EUROPAC detected precursor lesions or pancreatic cancers were stage II or lower. Conclusion The risk-stratified group (FR) identifies neoplastic pancreatic lesion in individuals, regardless of PV status suggesting the key usefulness of this approach.
Author(s): Hopley PJ, Peysner R, Boughey A, Kewlani B, Smith AM, Aithal GP, Oppong KW, Finch-Jones M, Hamady Z, Athwal TS, Milburn J, Menon S, Chapman M, Pereira SP, Taylor M, Shingler G, Briggs C, Ghaneh P, Costello E, Greenhalf W, Halloran CM
Publication type: Article
Publication status: Published
Journal: European Journal of Cancer
Year: 2026
Volume: 237
Online publication date: 17/02/2026
Acceptance date: 13/02/2026
Date deposited: 09/03/2026
ISSN (print): 0959-8049
ISSN (electronic): 1879-0852
Publisher: Elsevier Ltd
URL: https://doi.org/10.1016/j.ejca.2026.116592
DOI: 10.1016/j.ejca.2026.116592
Altmetrics provided by Altmetric
