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  • 1
    Publication Date: 2012-12-05
    Description: Communication about colorectal cancer screening in Britain: public preferences for an expert recommendation British Journal of Cancer 107, 1938 (04 December 2012). doi:10.1038/bjc.2012.512 Authors: J Waller, A Macedo, C von Wagner, A E Simon, C Jones, V Hammersley, D Weller, J Wardle & C Campbell
    Keywords: cancer screeningFOBTbenefits and risksrecommendationtrust
    Print ISSN: 0007-0920
    Electronic ISSN: 1532-1827
    Topics: Medicine
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  • 2
    Publication Date: 2012-06-19
    Description: Background CDKN2A -mutation carriers run a high risk of developing melanomas and have an increased risk of developing pancreatic cancer (PC). Familial PC (FPC) patients with a personal history or family history of melanomas are therefore offered CDKN2A -mutation analysis. In contrast, CDKN2A testing in FPC families without a history of melanomas is not generally recommended. The aim of this study was to evaluate the frequency of CDKN2A -mutations in FPC families without melanomas. Methods Data were gathered from PC family registers. FPC families were defined as families with clustering of PC without meeting diagnostic criteria of familial cutaneous malignant melanoma (familial CMM) or other inherited cancer syndromes. Blood samples were obtained for DNA isolation from PC patients or first degree relatives and analysed for CDKN2A -mutations. Results Among 40 FPC families, DNA analyses were carried out in 28 families (70%), leading to identification of CDKN2A -mutations in six families (21%). None of the CDKN2A -mutation-positive families fulfilled the diagnostic criteria for familial CMM and in three CDKN2A families no melanomas were observed. Two CDKN2A -mutations were found; the Dutch founder mutation p16-Leiden (c.225_243del, p.Ala76fs) and the c.19_23dup, p.Ser8fs-mutation. After disclosure of the CDKN2A -mutation in one of the families, a curable melanoma was diagnosed at dermatological surveillance in a 17-year-old family member. Conclusion CDKN2A -mutation can be found in a considerable proportion of families with FPC. CDKN2A -mutation analysis should therefore be included in genetic testing in FPC families, even in the absence of reported melanomas. This strategy will enhance the recognition of individuals at risk for PC and facilitate the early detection of melanomas.
    Keywords: Pancreas and biliary tract, Skin cancer, Screening (oncology), Dermatology
    Print ISSN: 0022-2593
    Electronic ISSN: 1468-6244
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 3
    Publication Date: 2012-12-14
    Description: Background Although Peutz-Jeghers syndrome (PJS) is known to be associated with pancreatic cancer (PC), estimates of this risk differ widely. This hampers counselling of patients and implementation of surveillance strategies. We therefore aimed to determine the PC risk in a large cohort of Dutch PJS patients. Methods PJS was defined by diagnostic criteria recommended by the WHO, a proven LKB1 mutation, or both. All patients with a presumptive diagnosis of pancreatic, ampullary or distal bile duct cancer were identified. Cases were reviewed clinically, radiologically and immunohistochemically. Cumulative PC risks were calculated by Kaplan-Meier analysis and relative risks by Poisson regression analysis. Results We included 144 PJS patients (49% male) from 61 families (5640 person years follow-up). Seven (5%) patients developed PC at a median age of 54 years. Four patients (3%) were diagnosed with distal bile duct (n=2) or ampullary cancer (n=2) at a median age of 55 years. The cumulative risk for PC was 26% (95% CI 4% to 47%) at age 70 years and relative risk was 76 (95% CI 36 to 160; p〈0.001). The cumulative risk for pancreatico-biliary cancer was 32% (95% CI 11% to 52%) at age 70 years, with a relative risk of 96 (95% CI 53 to 174; p〈0.001). Conclusions PJS patients have a highly increased risk for pancreatico-biliary cancer. Therefore, patients are eligible for surveillance within well defined research programmes to establish the benefit of such surveillance.
    Keywords: Pancreas and biliary tract, Dermatology, Epidemiology
    Print ISSN: 0022-2593
    Electronic ISSN: 1468-6244
    Topics: Medicine
    Published by BMJ Publishing Group
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