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 often panic. They insist on having frequent CT scans and biopsies to monitor the lesion, or they ask for surgery. Physicians also don't 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. But an international team of physicians, led by researchers at the Mayo Clinic campus in Jacksonville, Florida, has now developed a profile of the patient s who would be most at risk of developing lesions that are most likely to develop into cancer. The Mayo analysis was published online on April 10, 2015 in the journal Digestive and Liver Diseases. The article is titled “Risk Factors for Malignant Progression of Intraductal Papillary Mucinous Neoplasms.” "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, Michael B. Wallace, M.D., M.P.H., a gastroenterologist at the Mayo Clinic. "High-risk 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 its 95 percent fatal -- so we're seeking ways to understand who is at risk," Dr. Wallace says. "Our study offers valuable insight into the problem." The lesions evaluated in this study that can become cancerous are known as intraductal papillary mucinous neoplasms. They are common. "Between 10 and 40 percent of people have them," Dr. Wallace says.
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