Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2015; 21(6): 1707-1717
Published online Feb 14, 2015. doi: 10.3748/wjg.v21.i6.1707
Pancreatic cancer early detection: Expanding higher-risk group with clinical and metabolomics parameters
Shiro Urayama
Shiro Urayama, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of California, Davis, Sacramento, CA 95817, United States
Author contributions: Urayama S conceived and wrote the paper.
Conflict-of-interest: The author has no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shiro Urayama, MD, Professor, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of California, Davis, 4150 V Street, PSSB Suite 3500, Sacramento, CA 95817, United States. surayama@ucdavis.edu
Telephone: +1-916-7347021 Fax: +1-916-7347908
Received: July 8, 2014
Peer-review started: July 8, 2014
First decision: August 15, 2014
Revised: October 1, 2014
Accepted: January 8, 2015
Article in press: January 8, 2015
Published online: February 14, 2015
Abstract

Pancreatic ductal adenocarcinoma (PDAC) is the fourth and fifth leading cause of cancer death for each gender in developed countries. With lack of effective treatment and screening scheme available for the general population, the mortality rate is expected to increase over the next several decades in contrast to the other major malignancies such as lung, breast, prostate and colorectal cancers. Endoscopic ultrasound, with its highest level of detection capacity of smaller pancreatic lesions, is the commonly employed and preferred clinical imaging-based PDAC detection method. Various molecular biomarkers have been investigated for characterization of the disease, but none are shown to be useful or validated for clinical utilization for early detection. As seen from studies of a small subset of familial or genetically high-risk PDAC groups, the higher yield and utility of imaging-based screening methods are demonstrated for these groups. Multiple recent studies on the unique cancer metabolism including PDAC, demonstrate the potential for utility of the metabolites as the discriminant markers for this disease. In order to generate an early PDAC detection screening strategy available for a wider population, we propose to expand the population of higher risk PDAC group with combination clinical and metabolomics parameters.

Keywords: Pancreatic cancer, Endoscopic ultrasound, Metabolomics, Early detection, Biomarkers

Core tip: This is a summary of current pancreatic cancer cohort early detection studies and a potential approach being considered for future application. This is an area that requires heightened efforts as lack of effective treatment and screening scheme for wider population is leading this particular disease to be the second lethal cancer by 2030.