Early detection offers one of the best hopes for a cure. Unfortunately, there are no proven effective early detection tests currently available. We have therefore assembled a team at Hopkins whose focus is to develop and test new approaches to the early detection of pancreatic cancer and its precursors.

Pancreatic Cancer Early Detection team at Johns Hopkins brings together experts in gastroenterology, pathology, radiology, surgery and genetics using advances in genetic research and diagnostic technologies to create a multidisciplinary early detection research program. Much of the team's efforts are focused on individuals and families who have an elevated lifetime risk of developing pancreatic cancer.

Pancreas cancer is an aggressive disease that is difficult to treat, often because it is not detected until it has reached an advanced stage or spread throughout the body. Early detection screening aims to catch the early precancerous lesions and small pancreatic cancers that often present without symptoms with the goal of our research is to develop new approaches to detect and treat the disease when it is operable and before it has spread systemically.

Pancreatic cancer screening, mostly as a part of an ongoing research study, is offered for individuals who have a high risk of developing pancreatic cancer based on their family history, genetic predispositions and certain diagnoses.

Pancreas Surveillance

Pancreatic cancer screening is not appropriate for everyone, individuals without risk factors should not consider pancreas surveillance. However, participating in a research screening program may be appropriate for people who have certain risk factors, including family history and certain genetic syndromes that increase susceptibility to pancreas cancer. Surveillance is may also be clinically recommended in other instances such as new diagnoses of a pancreas cyst or lesion. If you are looking to learn more about following pancreatic cysts please follow the link to our Multidisciplinary Pancreatic Cyst Program.

At this point no early detection test has been shown to decrease incidence of pancreatic cancer related deaths. However, many experts believe that individuals should undergo regular early detection tests to survey their pancreas when they have a relative risk of developing pancreatic cancer greater than fivefold of the risk in the general population. Regular surveillance uses medical imaging and endoscopic techniques to detect precancerous lesions or early pancreatic cancer that can be surgically removed.

Our physicians work with each person considering pancreatic cancer screening to evaluate your risk factors and develop a screening plan appropriate to you. The list below can help you identify if you would benefit from a clinical evaluation.

Family History   

Pancreatic cancers sometimes run in families, patients who have a family history of pancreatic cancer are more likely to develop this disease. If you have a family history of pancreatic cancer you should consider early detection tests based on the following guidelines if:

  1. You have more than one first degree relative (parents, siblings or children) who have developed pancreatic cancer.
  2. You have first degree relatives (parents, siblings or children) who developed pancreas cancer before the age of 50.
  3. One of your first degree relatives has developed pancreatic cancer and at least one of your second or third degree relatives has developed pancreatic cancer (i.e. One parent and one uncle, or a sibling and a cousin).
  4. More than two of your second degree relatives (aunts, uncles, nieces and nephews) have developed pancreatic cancer.
  5. You have three or more relatives of any relation who have developed pancreatic cancer

Genetic Variations   

People who have a history of any of the following genetic variations and syndromes should consider pancreas cancer screening in a research setting.

  1. Individuals who have the BRCA1, BRCA2 or PALB2 mutation and have at least one relative affected by pancreatic cancer may wish to consider pancreas screening. These mutations are associated with a history of breast and/or ovarian cancer and are more common amongst people of Ashkenazi Jewish descent.
  2. People with Peutz-Jeghers syndrome associated with STK11 gene mutations may wish to begin pancreas cancer screening at age 40 regardless of their family history.
  3. Familial Atypical Mole Melanoma (FAMMM) occurs in families with histories of melanoma. This is associated with inherited mutations in the CDKN2A/p16 gene. Individuals with FAMMM and a mutation in CDKN2A who have at least one relative affected by pancreatic cancer may wish to consider pancreas cancer screening.
  4. Individuals who have hereditary pancreatitis are at a higher risk for developing pancreatic cancer. Hereditary pancreatitis is associated with episodes of pancreatitis starting at an early age. The chronic inflammation caused by pancreatitis and mutations in the PRSS1 gene associated with hereditary pancreatitis are both risk factors that increase pancreatic cancer risk. Individuals with hereditary pancreatitis and known PRSS1 should be screened for pancreatic cancer starting at age 40.
  5. Hereditary nonpolyposis colorectal cancer syndrome (HNPCC) or Lynch syndrome is a genetic syndrome affecting mismatch repair genes that increases the risk for colon, endometrial, stomach, ovarian and pancreas cancers. Individuals with Lynch syndrome who have at least one family member affected by pancreatic cancer may wish to consider screening for pancreatic cancer.
  6. Ataxia-telangiectasia syndrome caused by mutations in ATM gene who have at least one should be screened for pancreatic cancer (ATM) mutation carriers who have at least one family member affected by pancreas cancer may wish to consider screening

What kind of pancreas screening tests are available?   

Screening is usually performed in a research setting. This allows the team to define the best techniques for screening, and who would benefit most from screening. Most commonly it involves a combination of EUS, MRI and CT scans at regular intervals.

At The Johns Hopkins Hospital you will meet with one of our physicians before beginning screening to discuss your risk and develop a plan appropriate to you. Our team of radiologists, gastroenterologists, endoscopists, surgeons, pathologists and genetic counselors work together to create screening plans and make recommendations to individuals and family members. Genetic testing and genetic counseling are an optional part of pancreatic screening that may help some individuals understand their risk factors.

  • EUS - considered one of the most accurate tools for detection of small lesions that are not visible by CT scan. During an Endoscopic Ultrasound (EUS), is procedure a doctor passes an endoscope with an ultrasound probe attached to it through the patient's mouth and into the stomach where we are able to scan the pancreas. EUS also does not involve ionizing radiation, it produces images of the pancreas through the stomach using ultrasound waves bounce off internal organs.
    Fine needle aspirates can also be used in EUS to make certain diagnoses.
  • MRI - Imaging that uses strong magnetic fields to provide detailed pictures of internal organs.
    Secretin, a synthetic version of a hormone that stimulates your pancreas to produce juice is sometimes used in MRI, both to evaluate the function of your pancreas and to collect pancreatic juice secretions that may have diagnostic or research purposes.
  • CT - uses a combination of x-rays and computer technology to produce horizontal images, often called slices, of the body. Computed Tomography (CT) scans of the pancreas provide detailed images of the organ. You may want to ask your doctor about the amount of radiation used in a CT scan and the risks related to your particular situations.

CAPS group

Scheduling Pancreas Surveillance

Our team of experts is dedicated to helping patients navigate their questions about pancreas surveillance. Drs. Goggins and Canto are widely recognized as authorities in the field of pancreatic cancer screening, and have been working together to evaluate the utility of pancreatic screening for approximately 15 years. If you would like to schedule an appointment to participate in our research, and to begin pancreas screening please contact Dr. Michael Goggins office at 410-502-5612 or Dr. Marcia Canto at 410-614-5388 for information.


The Pancreatic Cancer Early Detection Lab at the Sol Goldman Pancreatic Cancer Research center focuses on the primary goal of discovering the next breakthroughs in pancreatic cancer early detection. This lab puts together many techniques with a focus on genetics and evaluating the effectiveness of emerging detection methods including the utility of biomarkers in diagnosing early pancreatic cancer. We study both the genes that increase pancreatic cancer risk and the genetic changes that take place in pancreas tumors and precancerous lesions. Our team looks at different aspects of changes in pancreatic cancer, such as the methylation of certain genes and the activity of enzymes like telomerase that are involved in the development of tumors to understand what genetic signatures or proteins could be used to identify early pancreatic cancer.

Participating in the CAPS Research Study

Cancer of the Pancreas Screening (CAPS):

The Cancer of the Pancreas Screening Study (CAPS) is a research program developed to evaluate the effectiveness of early detection screening in high risk individuals of pancreatic cancer, and to progress the discovery of new biomarkers to improve early detection. Our research team can help you understand more about participating in our research if you are interested.

The lead study coordinator and research nurse, Hilary Cosby (R.N., C.G.R.N.) assists with scheduling of pancreas screening including gastroenterology consultation, scheduling of EUS, MRI, CT and incorporating optional genetic counseling into your visits.

To answer questions or schedule participation in the CAPS Research Study please contact Hilary Cosby at 410-502-2893.