HRIs include the following patients [49]: individuals who have at least one first-degree relative with pancreatic cancer who in turn also have a first-degree relative with pancreatic cancer; all patients with Peutz-Jeghers syndrome; all carriers of a germline CDKN2A mutation; and carriers of a germline BRCA, BRCA1, PALB2, ATM, MLH1, MSH2, or MSH6 gene mutation with at least one affected first-degree blood relative. Here, MLH1 is linked to familial pancreatic carcinoma.