Early Diagnosis of Pancreatic Cancer: Clinical Premonitions, Timely Precursor Detection and Increased Curative-Intent Surgery

Sep 24, 2026

Background: Pancreatic cancer has a poor prognosis largely because diagnosis is often delayed. Early diagnosis remains a major challenge, and clinical symptoms typically emerge only when disease is already advanced or metastatic. Analysis and results: No dedicated clinical diagnostic or screening tests are widely used; research focuses on risk groups, preclinical factors, biomarkers, and “omics.” Many biomarker findings lack external validation and show limited accuracy, while tissue timing in studies complicates clinical translation. Conclusions: Review highlights new technologies, including image-based radiomics, AI/ML, and analytics of body fluids (“liquid biopsies”).

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Abstract

Introduction

Screening rationale and WHO criteria

Early Diagnosis of Pancreatic Cancer: Clinical Premonitions, Timely Precursor Detection and Increased Curative-Intent Surgery Cancer Control Volume 30: 1–14 © The Author(s) 2023 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions) [DOI: 10.1177/10732748231154711](DOI: 10.1177/10732748231154711)[ ](DOI: 10.1177/10732748231154711)[journals.sagepub.com/home/ccx](journals.sagepub.com/home/ccx) Kjetil Søreide, MD, PhD, FRCS (Edin), FACS, FEBS (hon) 1,2,3 􀀁, Warsan Ismail, MD1, Marcus Roalsø, MD 1,3,4, Jacob Ghotbi, MD 1, and Claudia Zaharia, MD3,5 Abstract Background: The overall poor prognosis in pancreatic cancer is related to late clinical detection. Early diagnosis remains a considerable challenge in pancreatic cancer. Unfortunately, the onset of clinical symptoms in patients usually indicate advanced disease or presence of metastasis. Analysis and Results: Currently, there are no designated diagnostic or screening tests for pancreatic cancer in clinical use. Thus, identifying risk groups, preclinical risk factors or surveillance strategies to facilitate early detection is a target for ongoing research. Hereditary genetic syndromes are a obvious, but small group at risk, and warrants close surveillance as suggested by society guidelines. Screening for pancreatic cancer in asymptomatic individuals is currently associated with the risk of false positive tests and, thus, risk of harms that outweigh beneﬁts. The promise of cancer biomarkers and use of ‘omics’ technology (genomic, transcriptomics, metabolomics etc.) has yet to see a clinical breakthrough. Several proposed biomarker studies for early cancer detection lack external validation or, when externally validated, have shown considerably lower accuracy than in the original data. Biopsies or tissues are often taken at the time of diagnosis in research studies, hence invalidating the value of a time-dependent lag of the biomarker to detect a pre-clinical, asymptomatic yet operable cancer. New technologies will be essential for early diagnosis, with emerging data from image-based radiomics approaches, artiﬁcial intelligence and machine learning suggesting avenues for improved detection. Conclusions: Early detection may come from analytics of various body ﬂuids (eg ‘liquid biopsies’ from blood or urine). In this review we present some the technological platforms that are explored for their ability to detect pancreatic cancer, some of which may eventually change the prospects and outcomes of patients with pancreatic cancer. Keywords screening, early detection, biomarker, radiology, diagnosis, curative surgery, prevention, early diagnosis, liquid biopsy Received October 9, 2022. Received revised January 10, 2023. Accepted for publication January 16, 2023. Introduction Pancreatic cancer is increasing in incidence and will soon become a major cause of cancer-related deaths in several parts of the world.1 Pancreatic cancers are typically diagnosed at a time when the patients have developed symptoms, usually indicating locally unresectable disease and/or metastasis.2,3 Currently, only 15-20% are diagnosed at a stage when curative surgery may be considered (Figure 1) . Unfortunately, 1 Department of Gastrointestinal Surgery, HPB unit, Stavanger University Hospital, Stavanger, Norway 2Department of Clinical Medicine, University of Bergen, Bergen, Norway 3Gastrointestinal Translational Research Group, Laboratory for Molecular Medicine, Stavanger University Hospital, Stavanger, Norway 4Department of Quality and Health Technology, University of Stavanger, Stavanger, Norway 5Department of Pathology, Stavanger University Hospital, Stavanger, Norway Corresponding Author: Kjetil Søreide, Department of Gastrointestinal Surgery, HPB unit, Stavanger University Hospital, POB 8100, Stavanger 4068, Norway. Email: [ksoreide@mac.com](ksoreide@mac.com) Creative Commons CC BY: This article is distributed under the terms

FAQs

Why is early diagnosis of pancreatic cancer difficult?

Overall prognosis is poor because clinical detection is usually late. Symptoms often appear only when patients already have advanced disease or metastasis, making early-stage identification challenging.

Are there established diagnostic or screening tests for pancreatic cancer in clinical practice?

No designated diagnostic or screening tests are currently used clinically. Research instead targets risk groups, preclinical risk factors, surveillance strategies, and potential biomarkers.

What approaches does the review suggest for earlier detection?

The review discusses emerging directions such as cancer biomarkers and “omics,” but also emphasizes limitations in validation and accuracy. It highlights new technologies including image-based radiomics, artificial intelligence/machine learning, and liquid biopsies from blood or urine.

Sep 24, 2026

Uploaded by LangkahRina