P4300 - Risk of Pancreatic Cyst in Genetic High-Risk Group Among Patients From EUS Pancreas Registry

Aida Nasirishargh, MD¹, Jiten H. Desai, MD², Shiro Urayama, MD³
1University of California Davis Health, Sacramento, CA; 2UC Davis Medical Center, Sacramento, CA; 3University of California, Davis, Sacramento, CA

Introduction: Pancreatic cysts and certain genetically high-risk [GHR] groups are routinely under surveillance/screening for pancreatic cancer early detection. The degree of influence of pancreatic cysts in genetically high-risk groups requires further characterization for future management. Here we describe the comparison of groups with either genetic-risks and/or suspected pancreatic mucinous cysts from the institutional EUS Pancreas Registry

Methods: Data were obtained from the institutional IRB-approved EUS Pancreas Registry for pancreatic disease. Three groups were examined: GHR individuals (family history of pancreatic ductal adenocarcinoma [PDAC] or presence of high-risk genetic mutations) without cysts (Group 1), GHR individuals with cysts (Group 2), and individuals with a history of pancreatic cysts alone (Group 3). Fukuoka and Kyoto guideline risk features were counted and summed for each case and metric was calculated for per-year risk feature development. Those with pancreatitis related cysts, serous cysts, neuroendocrine tumor, pancreaticobiliary cancer without cyst were excluded.

Descriptive statistics and non-parametric comparisons (Kruskal-Wallis with Bonferroni correction) were performed using SPSS v30. Statistical significance was set at p < 0.05.

Results: Of 220 patients (63.6% female; mean age 62.5 years), racial breakdown included 78.2% Caucasian, 8.2% Asian, 8.2% Hispanic, and 5.4% African American. Cancer or high-grade dysplasia was found in 0 of 49 cases (0%) in Group 1, 3 of 27 cases (11.1%) in Group 2, and 30 of 144 cases (20.8%) in Group 3.

Guideline-based risk scoring showed no significant difference between Groups 1 and 2. However, significant differences were observed between Groups 1 and 3 (Fukuoka (p = 0.002) and Kyoto (p = 0.000)). Group 2 and Group 3 also showed significant differences (Fukuoka (p = 0.007) and Kyoto (p = 0.043)).

Discussion: An increasing trend of the observed cancer is seen in association with pancreatic cyst formation. Risk-feature-based scoring demonstrated significant differences under both the Fukuoka and Kyoto guidelines between the pancreatic cyst alone group and GHR groups (with and without cyst). The current risk-feature based strategy, however, did not definitively distinguish the risk of having a cyst within the GHR group. These findings highlight the potential value of data analysis in stratifying cancer risk and underscore the need for further research to refine risk assessment strategies.

Disclosures:
Aida Nasirishargh indicated no relevant financial relationships.
Jiten Desai indicated no relevant financial relationships.
Shiro Urayama: Merit Endotek – Consultant. Noah Medical – Consultant. Olympus America – Consultant.

Aida Nasirishargh, MD¹, Jiten H. Desai, MD², Shiro Urayama, MD³. P4300 - Risk of Pancreatic Cyst in Genetic High-Risk Group Among Patients From EUS Pancreas Registry, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.