Improving Management of patients at High Risk of Pancreatic Cancer - PROJECT ABSTRACT Our overall goal is to redefine screening for early detection of pancreatic cancer. Currently, endoscopic ultrasound and magnetic resonance imaging (MRI) is used to survey individuals at high risk of pancreatic cancer. These tests are costly, not easily accessible and of variable yield even in high-risk populations. Using state of the art methods, we will develop a highly specific blood based early-detection pancreatic cancer test with sensitivity and specificity appropriate for high-risk individuals. We will couple this with innovative approaches which will further leverage imaging, risk factor and germline genetic data to further stratify risk. We will integrate these diverse data to more precisely guide the management of high-risk patients. The specific aims of this project are: 1) To develop a blood based early detection screening test, PancSEEK, for populations at higher risk of PDAC. 2) To develop PDAC risk models that integrate clinical, genomic, molecular, and imaging data to enable personalized surveillance management plans for individuals at higher risk of PDAC. 3) To prospectively evaluate an integrated risk model, PancDetect, and the blood-based screening test, PancSEEK, in a population at higher risk of PDAC.