The Pancreatic Adenocarcinoma Gene Environment Risk Study - A Study of Patients at Risk or Having Pancreatic Disease (PAGER)

Early detection of precancerous lesions or very early cancers offers the best chance for curing cancer. Imaging of pancreatic masses by computed tomography (CT) scan, magnetic resonance imaging (MRI) or endoscopic ultrasound (EUS) with fine needle aspiration (FNA) for cytology is currently the most sensitive and specific method for early identification of pancreatic neoplasms. Unfortunately, current techniques require that the pancreatic mass is of a size when blood vessel invasion and metastasis have often already occurred. Thus, new approaches are needed to identify early pancreatic cancer before it is normally visible on imaging studies. Furthermore, the suspicion of pancreatic cancer can cause tremendous distress in patients, family members and their care givers, and lead to expensive and repeated evaluations and diagnostic procedures. Thus, new markers with high positive and negative predictive value are needed.

The investigators hypothesize that the most effective strategy to reduce the burden of pancreatic cancer is a systematic approach that utilizes new methods that stratify subjects from the general population by history (personal and/or family) or genetic tests into a high-risk cohort, then to screen patients at high risk with tests on blood, pancreatic juice or samples from fine needle aspiration of cystic or solid lesions for early detection, diagnosis or exclusion of pancreatic cancers or premalignant lesions (e.g., intraductal neoplasia (PanIN) lesions [1]). The investigators propose to identify new markers and develop a new test using biological samples and imaging technologies using complementary strategies.