Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 21, 2022; 28(31): 4235-4248
Published online Aug 21, 2022. doi: 10.3748/wjg.v28.i31.4235
Early diagnosis of pancreatic cancer: What strategies to avoid a foretold catastrophe
Valeria Tonini, Manuel Zanni
Valeria Tonini, Manuel Zanni, Department of Medical and Surgical Sciences, University of Bologna, Bologna 40138, Italy
Author contributions: Tonini V and Zanni M contributed equally to this work; Both authors designed the research study, wrote the manuscript and read and approved the final manuscript.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Valeria Tonini, MD, PhD, Adjunct Associate Professor, Professor, Surgeon, Surgical Oncologist, Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, Bologna 40138, Italy. valeria.tonini@unibo.it
Received: March 24, 2022
Peer-review started: March 24, 2022
First decision: May 9, 2022
Revised: May 18, 2022
Accepted: July 24, 2022
Article in press: July 24, 2022
Published online: August 21, 2022
Abstract

While great strides in improving survival rates have been made for most cancers in recent years, pancreatic ductal adenocarcinoma (PDAC) remains one of the solid tumors with the worst prognosis. PDAC mortality often overlaps with incidence. Surgical resection is the only potentially curative treatment, but it can be performed in a very limited number of cases. In order to improve the prognosis of PDAC, there are ideally two possible ways: the discovery of new strategies or drugs that will make it possible to treat the tumor more successfully or an earlier diagnosis that will allow patients to be operated on at a less advanced stage. The aim of this review was to summarize all the possible strategies available today for the early diagnosis of PDAC and the paths that research needs to take to make this goal ever closer. All the most recent studies on risk factors and screening modalities, new laboratory tests including liquid biopsy, new imaging methods and possible applications of artificial intelligence and machine learning were reviewed and commented on. Unfortunately, in 2022 the results for this type of cancer still remain discouraging, while a catastrophic increase in cases is expected in the coming years. The article was also written with the aim of highlighting the urgency of devoting more attention and resources to this pathology in order to reach a solution that seems more and more unreachable every day.

Keywords: Pancreatic cancer, Pancreatic ductal adenocarcinoma, Early diagnosis, Liquid biopsy, Pancreatic cancer biomarkers, Artificial intelligence, Pancreatic cancer screening

Core Tip: Pancreatic ductal adenocarcinoma is one of the solid neoplasms with the worst prognosis. Surgical resection is the only potentially curative treatment. In 80% of patients, pancreatic ductal adenocarcinoma is discovered at a stage too advanced for surgery. The aim of this review was to summarize all the possible strategies available today for the early diagnosis of pancreatic ductal adenocarcinoma and the paths that research must take to make this goal ever closer. The article highlights the urgency of devoting more attention and resources to this pathology in order to reach a solution that seems more and more unreachable every day.