Pancreatic Cancer Early Detection Consortium

⁃ Individuals from the following groups who present for clinical evaluation and assessment of PDAC risk at any of the participating sites can be offered participation in the PRECEDE database:

⁃ Cohort 1

⁃ Individuals without history of PDAC meeting any of the following criteria:

• 2+ relatives with PDAC on same side of family where 2 affected are first degree related to each other and at least 1 affected is first degree related to subject; age 50+ or ≤10 years younger than earliest PDAC in family at time of diagnosis.

• 2 affected first degree relatives with PDAC; age 50+ or 10 years younger than earliest PDAC in family

• BRCA1, BRCA2, PALB2, ATM, MLH1, MSH2, MSH6, PMS2, EPCAM pathogenic or likely pathogenic variant AND 1 first or second degree relative with PDAC; age 50+ or 10 years younger than earliest PDAC in family

• Familial Atypical Moles and Malignant Melanoma (FAMMM) with pathogenic or likely pathogenic CDKN2A variant; age 40+

• Peutz-Jegher syndrome with STK11 pathogenic or likely pathogenic variant; age 35+

• Hereditary pancreatitis with PRSS1 pathogenic or likely pathogenic variant and history of pancreatitis; age 40+

⁃ Cohort 2

⁃ Individuals without history of PDAC meeting any of the following criteria:

• ATM, BRCA1, BRCA2, or PALB2 pathogenic or likely pathogenic variant regardless of family history, age 50+

• 2+ relatives with PDAC on the same side of family, any degree of relation, not meeting other criteria above; age 50+ or 10 years younger than earliest PDAC in family

• 1 first degree relative with PDAC ≤ age 45; age up to 10 years younger than PDAC diagnosis in family member

⁃ Cohort 3 Individual meeting criteria for Cohorts 1 or 2 EXCEPT age (i.e. too young to qualify for Cohorts 1 or 2)

⁃ Cohort 4 Individuals without history of PDAC presenting for evaluation who do not meet any criteria for 1-3, 6, or the Cyst Cohort.

⁃ Cohort 5 Individuals without history of PDAC who are not otherwise engaged in pancreas surveillance at a participating site may be invited to participate in the PRECEDE database and to donate a biosample (e.g. blood, saliva, and/or buccal swab) for discovery studies. This may include relatives of individuals in Cohorts 1-4,6, and the Cyst Cohort.

⁃ Cohort 6a

⁃ Individuals diagnosed with PDAC after enrollment in PRECEDE meeting any of the following criteria:

• Family history includes at least one first degree relative with PDAC, or 2 relatives with PDAC who are first degree related to each other

• Personal or family history of a pathogenic or likely pathogenic germline variant in ATM, BRCA1, BRCA2, CDKN2A, EPCAM, MLH1, MSH2, MSH6, PALB2,PMS2, PRSS1, STK11

⁃ Cohort 6b

⁃ Individuals with a personal history of PDAC meeting any of the following criteria:

• Family history includes at least one first degree relative with PDAC, or 2 relatives with PDAC who are first degree related to each other

• Personal or family history of a pathogenic or likely pathogenic germline variant in ATM, BRCA1, BRCA2, CDKN2A, EPCAM, MLH1, MSH2, MSH6, PALB2,PMS2, PRSS1, STK11

• Diagnosed ≤ age 45

⁃ Cyst Cohort Individuals with a personal history of a pancreatic cystic neoplasm not meeting any criteria for Cohorts 1-3 or 6 (no known family history of PDAC, no known pathogenic germline variants linked to PDAC risk)