How to define patients at high risk for pancreatic cancer.

The clinical outcome of patients with pancreatic cancer remains dismal despite recent advances in diagnostic and therapeutic modalities. Several risk factors have been reported regarding the development of pancreatic cancer. These risk factors include family history, accompanying diseases, and lifestyle/personal habits. Family history includes that of pancreatic cancer and hereditary pancreatic cancer syndrome. Accompanying diseases that increase the risk include diabetes mellitus, obesity, chronic pancreatitis, hereditary pancreatic cancer syndrome and intraductal papillary mucinous neoplasms. Lifestyle-associated factors include smoking and diet. Detailed examination of patients with such risk factors is warranted, but the cost-benefit effect should be considered. Thus, patients with more than one risk factor should be carefully followed up, and periodic examination of such patients is necessary to ensure the detection of smaller and less-advanced pancreatic cancer lesions and thus to improve the clinical outcome of patients with pancreatic cancer.