Loading
CAPS is the Johns Hopkins-led programme that has followed people at high inherited risk of pancreatic cancer with yearly endoscopic ultrasound and MRI since the late 1990s, and the consortium whose consensus statements set who should be watched and how. Its cohorts are the evidence that surveillance finds most cancers at stage I.
The CAPS studies enrolled people with a strong family history or a known predisposition gene: in the long-term Johns Hopkins cohort of 354 high-risk individuals followed over 16 years, 7% progressed to high-grade dysplasia or cancer (about 1.6% a year), 93% had worrisome features first and 9 of 10 surveillance-detected cancers were resectable (Canto 2018). Across CAPS1 to CAPS5 (1,731 people; 1,461 in CAPS5 alone), 57.9% of the 19 cancers found under surveillance were stage I against 85.7% stage IV for the seven found outside it, with five-year survival 73.3% and median overall survival 9.8 years against 1.5 years (Dbouk 2022); 7 of 9 CAPS5 cancers were stage I. The International CAPS Consortium's 2020 consensus set the goal as high-grade dysplasia and T1N0M0 cancer, starts familial surveillance at 50 or 55 or ten years before the youngest affected relative, uses endoscopic ultrasound and MRI/MRCP yearly and admitted ATM carriers with one affected first-degree relative (Goggins 2020). NICE NG85's surveillance criteria and the UK EUROPAC registry follow the same logic; PRECEDE is building the international cohort that succeeds it.
Showing the technology this term belongs to: High-risk pancreatic surveillance (CAPS / PRECEDE).
The stage shift the pancreatic cancer page quotes (about three in four surveillance-detected cancers at stage I) and the strongest argument for offering surveillance to every germline carrier found by universal testing, which the NHS does not yet do outside research.
The rulebook behind the CAPS cohorts and the UK EUROPAC programme; it is also the reason surveillance for carriers is not yet a routine NHS service, because the consortium itself asked for it to stay within research until benefit was shown.
The first long-term evidence that surveillance in high-risk people finds operable cancers, and the source of the imaging features that trigger surgery in the CAPS recommendations.
Shares Stage shift, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, Pancreatic ductal adenocarcinoma and the tag pancreatic-molecular.
Shares Stage shift, Pancreatic ductal adenocarcinoma and the tag pancreatic-molecular.
Shares Pancreatic ductal adenocarcinoma and the tag pancreatic-molecular.
Shares Pancreatic ductal adenocarcinoma and the tag pancreatic-molecular.
Shares Pancreatic ductal adenocarcinoma and the tag pancreatic-molecular.
Shares Pancreatic ductal adenocarcinoma and the tag pancreatic-molecular.
Shares PRECEDE, Risk of Neoplastic Progression in Individuals at High Risk for Pancreatic Cancer Undergoing Long-term Surveillance, The Multicenter Cancer of Pancreas Screening Study: Impact on Stage and Survival, Management of patients with increased risk for familial pancreatic cancer: updated recommendations from the International Cancer of the Pancreas Screening (CAPS) Consortium.
Shares High-risk pancreatic surveillance (CAPS / PRECEDE), Hereditary cancer syndromes, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, Germline (hereditary) testing.