Editorial
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 28, 2012; 18(36): 4973-4977
Published online Sep 28, 2012. doi: 10.3748/wjg.v18.i36.4973
Pancreatic ductal adenocarcinoma screening: New perspectives
Raffaele Pezzilli, Dario Fabbri, Andrea Imbrogno
Raffaele Pezzilli, Dario Fabbri, Andrea Imbrogno, Department of Digestive Diseases and Internal Medicine, Sant’Orsola-Malpighi Hospital, 40138 Bologna, Italy
Author contributions: Pezzilli R, Fabbri D and Imbrogno A collected the literature data; Pezzilli R analyzed the data and interpreted the results; and Pezzilli R designed the study and wrote the manuscript.
Correspondence to: Raffaele Pezzilli, MD, Department of Digestive Diseases and Internal Medicine, Sant’Orsola-Malpighi Hospital, 40138 Bologna, Italy. raffaele.pezzilli@aosp.bo.it
Telephone: +39-51-6364148 Fax: +39-51-6364148
Received: February 21, 2012
Revised: April 20, 2012
Accepted: May 26, 2012
Published online: September 28, 2012
Abstract

Pancreatic ductal adenocarcinoma accounts for more than 90% of all pancreatic cancers and its incidence has increased significantly worldwide. Patients with pancreatic ductal adenocarcinoma have a poor outcome and more than 95% of the people affected die from the disease within 12 mo after diagnosis. Surgery is the first-line treatment in the case of resectable neoplasm, but only 20% of patients are candidates for this approach. One of the reasons there are few candidates for surgery is that, during the early phases of the disease, the symptoms are poor or non-specific. Early diagnosis is of crucial importance to improve patient outcome; therefore, we are looking for a good screening test. The screening test must identify the disease in an early stage in order to be effective; having said this, a need exists to introduce the concept of “early” ductal adenocarcinoma. It has been reported that at least five additional years after the occurrence of the initiating mutation are required for the acquisition of metastatic ability of pancreatic adenocarcinoma and patients die an average of two years thereafter. We have reviewed the most recent literature in order to evaluate the present and future perspectives of screening programs of this deadly disease.

Keywords: Pancreatic neoplasms; Study population; Prevention; Therapeutics