Inclusion Criteria:

- The modified clinical Bethesda criteria for HNPCC, which are as follows: individuals
with 2 HNPCC-associated cancers (colon, endometrial, small bowel, hepatobiliary,
pancreatic, genitourinary, or gastric), including synchronous or metachronous
lesions; individuals with colon cancer and a first degree relative with an
HNPCC-associated tumor and/or colonic adenoma (1 cancer diagnosed at age <45 years
and the adenoma diagnosed at age <40 years); individuals with colon or endometrial
cancer diagnosed at <50 years; individuals with right-sided colon cancer having an
undifferentiated pattern (solid/cribiform) or signet cell histopathology diagnosed at
<45 years; or individuals with adenomas diagnosed at <40 years.

- Those with a personal or family history of other pancreatic cancer associated
syndromes including: Peutz-Jeghers syndrome, familial pancreatic cancer syndrome,
familial breast cancer syndrome associated with BRCA-2 or BRCA-1, hereditary
pancreatitis, familial atypical multiple mole melanoma, and others.

- Patients in a family with a genetically determined cancer predisposition syndrome.

- Patients with a personal history of a gastrointestinal malignancy at age <45 years.

- Individuals at high-risk based on personal or family history, but not related to a
known pancreatic cancer syndrome include the following: those with a personal history
of pancreatic cancer, or a pre-neoplastic pancreatic lesion; those with a family
history of two or more individuals with cancer, at least one of which is reported to
be a gastrointestinal malignancy; a history of early onset (<50 years)
gastrointestinal cancer in the individual or a family member; a history of multiple
primary cancers, at least one of which is a gastrointestinal primary, or a family
member of an individual meeting this criterion.

Exclusion Criteria:

- Inability to obtain informed consent for study enrollment.

- Under the age of 18 years old.