Creating a Profile to ID Those Most at Risk.

• Position: PANCREATIC CANCER

When people find out--usually from a diagnostic scan looking at something else--that they have a lesion in their pancreas that could morph into pancreatic cancer, they quite often panic. They insist on having frequent CT scans and biopsies to monitor the lesion, or they ask for surgery. Physicians also do not know if these abnormalities are dangerous, so the patients end up in surgery having part of their pancreas removed. Often the lesion is nothing to worry about.

However, a team of international physicians, led by researchers at Mayo Clinic's campus in Jacksonville, Fla., has developed a profile of the patient who would be most at risk of developing lesions that are most likely to develop into cancer. Their analysis is published in Digestive and Liver Diseases.

'The factors we found that increase risk of pancreatic cancer now allow us to separate patients as either low or high risk," says the study's senior author, gastroenterologist Michael B. Wallace. "Highrisk patients can then be scanned and biopsied more frequently or can opt for surgery, but low-risk patients don't need such surveillance. They can be watched much less intensively.

"Pancreatic cancer is difficult to detect early--most patients are diagnosed at later stages when ifs 95% fatal--so we're seeking ways to understand who is at risk."

The lesions evaluated in this study that can become cancerous are known as intraductal papillary mucinous neoplasms. They are common. "Between 10% and 40% of people have them. Obviously the vast...