Tailored Surveillance Strategies for Pancreatic Cancer in Patients with Chronic Pancreatitis

초록

Chronic pancreatitis, a significant risk factor for pancreatic cancer, necessitates monitoring forpancreatic cancer development. Chronic pancreatitis can be broadly categorized into hereditaryand sporadic. Given the variability in the risk for pancreatic cancer based on the presence andtype of genetic mutations, it is crucial to establish and be aware of guidelines for screening andsurveillance tailored to each risk level. In cases of hereditary chronic pancreatitis with PRSS1mutations, patients demonstrated a high incidence of pancreatic cancer, justifying the rationalefor screening and surveillance. However, the incidence of pancreatic cancer is relatively low inhereditary chronic pancreatitis with other genetic mutations and sporadic chronic pancreatitis;thus, precise screening and periodic surveillance are not recommended. For individuals withPRSS1 mutation-related hereditary chronic pancreatitis, surveillance may be considered fromthe age of 40 years. While computed tomography or magnetic resonance imaging is suitablefor pancreatic cancer screening, endoscopic ultrasonography is not recommended because ofparenchymal inflammation, fibrosis, and calcification. However, in cases of sporadic chronicpancreatitis where various risk factors for pancreatic cancer coexist, the incidence of pancreaticcancer significantly increases. Therefore, in 5 years after the diagnosis of chronic pancreatitis,the pancreatic cancer incidence has been observed to continuously increase. In such cases,individualized screening tests and surveillance based on the patient’s symptoms and specificcircumstances must be considered.

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