Epidemiology of pancreatic cancer

Milena Ilic, Irena Ilic, Milena Ilic, Irena Ilic

Abstract

Cancer of the pancreas remains one of the deadliest cancer types. Based on the GLOBOCAN 2012 estimates, pancreatic cancer causes more than 331000 deaths per year, ranking as the seventh leading cause of cancer death in both sexes together. Globally, about 338000 people had pancreatic cancer in 2012, making it the 11th most common cancer. The highest incidence and mortality rates of pancreatic cancer are found in developed countries. Trends for pancreatic cancer incidence and mortality varied considerably in the world. A known cause of pancreatic cancer is tobacco smoking. This risk factor is likely to explain some of the international variations and gender differences. The overall five-year survival rate is about 6% (ranges from 2% to 9%), but this vary very small between developed and developing countries. To date, the causes of pancreatic cancer are still insufficiently known, although certain risk factors have been identified, such as smoking, obesity, genetics, diabetes, diet, inactivity. There are no current screening recommendations for pancreatic cancer, so primary prevention is of utmost importance. A better understanding of the etiology and identifying the risk factors is essential for the primary prevention of this disease.

Keywords: Epidemiology; Incidence; Mortality; Pancreatic cancer; Risk factors; Trend.

Conflict of interest statement

Conflict-of-interest statement: No potential conflicts of interest.

Figures

Figure 1
Figure 1
Pancreatic cancer incidence and mortality in men and women, by regions, GLOBOCAN 2012 estimates.
Figure 2
Figure 2
Pancreatic cancer incidence in men (A) and women (B), GLOBOCAN 2012 estimates. 1Country with the lowest mortality rates; 2Country with the highest mortality rates. GLOBOCAN 2012 estimates[1].
Figure 3
Figure 3
Pancreatic cancer mortality in men (A) and women (B), GLOBOCAN 2012 estimates. 1Country with the lowest mortality rates; 2Country with the highest mortality rates. GLOBOCAN 2012 estimates[1].
Figure 4
Figure 4
Pancreatic cancer mortality trends among men (A) and women (B) in selected countries. GLOBOCAN 2012 estimates[1].

References

    1. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. Lyon, France: International Agency for Research on Cancer; 2013. Accessed 2016-03-04. Available from: .
    1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359–E386.
    1. Howlader N, Noone AM, Krapcho M, Miller D, Bishop K, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA. SEER Cancer Statistics Review, 1975-2013, National Cancer Institute. Bethesda, MD, 2016. Available from:
    1. Hidalgo M, Cascinu S, Kleeff J, Labianca R, Löhr JM, Neoptolemos J, Real FX, Van Laethem JL, Heinemann V. Addressing the challenges of pancreatic cancer: future directions for improving outcomes. Pancreatology. 2013;15:8–18.
    1. Vincent A, Herman J, Schulick R, Hruban RH, Goggins M. Pancreatic cancer. Lancet. 2011;378:607–620.
    1. Malvezzi M, Carioli G, Bertuccio P, Rosso T, Boffetta P, Levi F, La Vecchia C, Negri E. European cancer mortality predictions for the year 2016 with focus on leukaemias. Ann Oncol. 2016;27:725–731.
    1. Qiu D, Katanoda K, Marugame T, Sobue T. A Joinpoint regression analysis of long-term trends in cancer mortality in Japan (1958-2004) Int J Cancer. 2009;124:443–448.
    1. Wang L, Yang GH, Lu XH, Huang ZJ, Li H. Pancreatic cancer mortality in China (1991-2000) World J Gastroenterol. 2003;9:1819–1823.
    1. Parkin DM, Boyd L, Walker LC. 16. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Br J Cancer. 2011;105 Suppl 2:S77–S81.
    1. Hidalgo M. Pancreatic cancer. N Engl J Med. 2010;362:1605–1617.
    1. Ezzati M, Henley SJ, Lopez AD, Thun MJ. Role of smoking in global and regional cancer epidemiology: current patterns and data needs. Int J Cancer. 2005;116:963–971.
    1. Willett WC. Diet and cancer. Oncologist. 2000;5:393–404.
    1. Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P. Pancreatic cancer: overview of descriptive epidemiology. Mol Carcinog. 2012;51:3–13.
    1. Genkinger JM, Spiegelman D, Anderson KE, Bernstein L, van den Brandt PA, Calle EE, English DR, Folsom AR, Freudenheim JL, Fuchs CS, et al. A pooled analysis of 14 cohort studies of anthropometric factors and pancreatic cancer risk. Int J Cancer. 2011;129:1708–1717.
    1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55:74–108.
    1. Avgerinos DV, Björnsson J. Malignant neoplasms: discordance between clinical diagnoses and autopsy findings in 3,118 cases. APMIS. 2001;109:774–780.
    1. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, Forman D, Bray F. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013;49:1374–1403.
    1. Mathers CD, Fat DM, Inoue M, Rao C, Lopez AD. Counting the dead and what they died from: an assessment of the global status of cause of death data. Bull World Health Organ. 2005;83:171–177.
    1. Oberstein PE, Olive KP. Pancreatic cancer: why is it so hard to treat? Therap Adv Gastroenterol. 2013;6:321–337.
    1. Levi F, Lucchini F, Negri E, La Vecchia C. Pancreatic cancer mortality in Europe: the leveling of an epidemic. Pancreas. 2003;27:139–142.
    1. Sens MA, Zhou X, Weiland T, Cooley AM. Unexpected neoplasia in autopsies: potential implications for tissue and organ safety. Arch Pathol Lab Med. 2009;133:1923–1931.
    1. Karim-Kos HE, de Vries E, Soerjomataram I, Lemmens V, Siesling S, Coebergh JW. Recent trends of cancer in Europe: a combined approach of incidence, survival and mortality for 17 cancer sites since the 1990s. Eur J Cancer. 2008;44:1345–1389.
    1. Lambe M, Eloranta S, Wigertz A, Blomqvist P. Pancreatic cancer; reporting and long-term survival in Sweden. Acta Oncol. 2011;50:1220–1227.
    1. Weiss W, Benarde MA. The temporal relation between cigarette smoking and pancreatic cancer. Am J Public Health. 1983;73:1403–1404.
    1. Zhang J, Zhao Z, Berkel HJ. Animal fat consumption and pancreatic cancer incidence: evidence of interaction with cigarette smoking. Ann Epidemiol. 2005;15:500–508.
    1. Anderson KE, Mongin SJ, Sinha R, Stolzenberg-Solomon R, Gross MD, Ziegler RG, Mabie JE, Risch A, Kazin SS, Church TR. Pancreatic cancer risk: associations with meat-derived carcinogen intake in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) cohort. Mol Carcinog. 2012;51:128–137.
    1. Jarosz M, Sekuła W, Rychlik E. Influence of diet and tobacco smoking on pancreatic cancer incidence in poland in 1960-2008. Gastroenterol Res Pract. 2012;2012:682156.
    1. Ma J, Siegel R, Jemal A. Pancreatic cancer death rates by race among US men and women, 1970-2009. J Natl Cancer Inst. 2013;105:1694–1700.
    1. Ilić M, Vlajinac H, Marinković J, Kocev N. Pancreatic cancer mortality in Serbia from 1991-2010 - a joinpoint analysis. Croat Med J. 2013;54:369–375.
    1. Wingo PA, Cardinez CJ, Landis SH, Greenlee RT, Ries LA, Anderson RN, Thun MJ. Long-term trends in cancer mortality in the United States, 1930-1998. Cancer. 2003;97:3133–3275.
    1. La Vecchia C, Bosetti C, Lucchini F, Bertuccio P, Negri E, Boyle P, Levi F. Cancer mortality in Europe, 2000-2004, and an overview of trends since 1975. Ann Oncol. 2010;21:1323–1360.
    1. Huxley R, Ansary-Moghaddam A, Berrington de González A, Barzi F, Woodward M. Type-II diabetes and pancreatic cancer: a meta-analysis of 36 studies. Br J Cancer. 2005;92:2076–2083.
    1. International Agency for Research on Cancer. Tobacco Smoke and Involuntary Smoking - IARC Monographs on the Evaluation of Carcinogenic Risks to Humans,Vol. 83 Lyon: International Agency for research on Cancer WHO mortality database, WHO/Geneva, 2004) Available from: .
    1. Rastogi T, Devesa S, Mangtani P, Mathew A, Cooper N, Kao R, Sinha R. Cancer incidence rates among South Asians in four geographic regions: India, Singapore, UK and US. Int J Epidemiol. 2008;37:147–160.
    1. Hiripi E, Gondos A, Emrich K, Holleczek B, Katalinic A, Luttmann S, Sirri E, Brenner H. Survival from common and rare cancers in Germany in the early 21st century. Ann Oncol. 2012;23:472–479.
    1. Anderson RN, Miniño AM, Hoyert DL, Rosenberg HM. Comparability of cause of death between ICD-9 and ICD-10: preliminary estimates. Natl Vital Stat Rep. 2001;49:1–32.
    1. Sant M, Aareleid T, Berrino F, Bielska Lasota M, Carli PM, Faivre J, Grosclaude P, Hédelin G, Matsuda T, Møller H, et al. EUROCARE-3: survival of cancer patients diagnosed 1990-94--results and commentary. Ann Oncol. 2003;14 Suppl 5:v61–118.
    1. Coleman MP, Forman D, Bryant H, Butler J, Rachet B, Maringe C, Nur U, Tracey E, Coory M, Hatcher J, et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995-2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet. 2011;377:127–138.
    1. Mitry E, Rachet B, Quinn MJ, Cooper N, Coleman MP. Survival from cancer of the pancreas in England and Wales up to 2001. Br J Cancer. 2008;99 Suppl 1:S21–S23.
    1. Pasquali C, Sperti C, Filipponi C, Pedrazzoli S. Epidemiology of pancreatic cancer in Northeastern Italy: incidence, resectability rate, hospital stay, costs and survival (1990-1992) Dig Liver Dis. 2002;34:723–731.
    1. Carrato A, Falcone A, Ducreux M, Valle JW, Parnaby A, Djazouli K, Alnwick-Allu K, Hutchings A, Palaska C, Parthenaki I. A Systematic Review of the Burden of Pancreatic Cancer in Europe: Real-World Impact on Survival, Quality of Life and Costs. J Gastrointest Cancer. 2015;46:201–211.
    1. Fesinmeyer MD, Austin MA, Li CI, De Roos AJ, Bowen DJ. Differences in survival by histologic type of pancreatic cancer. Cancer Epidemiol Biomarkers Prev. 2005;14:1766–1773.
    1. Sharma C, Eltawil KM, Renfrew PD, Walsh MJ, Molinari M. Advances in diagnosis, treatment and palliation of pancreatic carcinoma: 1990-2010. World J Gastroenterol. 2011;17:867–897.
    1. Klint A, Engholm G, Storm HH, Tryggvadóttir L, Gislum M, Hakulinen T, Bray F. Trends in survival of patients diagnosed with cancer of the digestive organs in the Nordic countries 1964-2003 followed up to the end of 2006. Acta Oncol. 2010;49:578–607.
    1. Saif MW. Pancreatic neoplasm in 2011: an update. JOP. 2011;12:316–321.
    1. Oh SY, Edwards A, Mandelson MT, Lin B, Dorer R, Helton WS, Kozarek RA, Picozzi VJ. Rare long-term survivors of pancreatic adenocarcinoma without curative resection. World J Gastroenterol. 2015;21:13574–13581.
    1. Beger HG, Rau B, Gansauge F, Leder G, Schwarz M, Poch B. Pancreatic cancer--low survival rates. Dtsch Arztebl Int. 2008;105:255–262.
    1. Dimastromatteo J, Houghton JL, Lewis JS, Kelly KA. Challenges of Pancreatic Cancer. Cancer J. 2015;21:188–193.
    1. Linder S, Boström L, Nilsson B. Pancreatic carcinoma incidence and survival in Sweden in 1980-2000: a population-based study of 16,758 hospitalized patients with special reference to different therapies. Eur J Surg Oncol. 2007;33:616–622.
    1. Yamamoto T, Yagi S, Kinoshita H, Sakamoto Y, Okada K, Uryuhara K, Morimoto T, Kaihara S, Hosotani R. Long-term survival after resection of pancreatic cancer: a single-center retrospective analysis. World J Gastroenterol. 2015;21:262–268.
    1. Brenner H, Hakulinen T. Population-based monitoring of cancer patient survival in situations with imperfect completeness of cancer registration. Br J Cancer. 2005;92:576–579.
    1. Anand P, Kunnumakkara AB, Sundaram C, Harikumar KB, Tharakan ST, Lai OS, Sung B, Aggarwal BB. Cancer is a preventable disease that requires major lifestyle changes. Pharm Res. 2008;25:2097–2116.
    1. Iodice S, Gandini S, Maisonneuve P, Lowenfels AB. Tobacco and the risk of pancreatic cancer: a review and meta-analysis. Langenbecks Arch Surg. 2008;393:535–545.
    1. Vrieling A, Bueno-de-Mesquita HB, Boshuizen HC, Michaud DS, Severinsen MT, Overvad K, Olsen A, Tjønneland A, Clavel-Chapelon F, Boutron-Ruault MC, et al. Cigarette smoking, environmental tobacco smoke exposure and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition. Int J Cancer. 2010;126:2394–2403.
    1. Lynch SM, Vrieling A, Lubin JH, Kraft P, Mendelsohn JB, Hartge P, Canzian F, Steplowski E, Arslan AA, Gross M, et al. Cigarette smoking and pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium. Am J Epidemiol. 2009;170:403–413.
    1. American Cancer Society. Cancer Facts and Figures 2013. Atlanta, Ga: American Cancer Society; 2013. Available from: .
    1. Silverman DT, Hoover RN, Brown LM, Swanson GM, Schiffman M, Greenberg RS, Hayes RB, Lillemoe KD, Schoenberg JB, Schwartz AG, et al. Why do Black Americans have a higher risk of pancreatic cancer than White Americans? Epidemiology. 2003;14:45–54.
    1. Jemal A, Simard EP, Xu J, Ma J, Anderson RN. Selected cancers with increasing mortality rates by educational attainment in 26 states in the United States, 1993-2007. Cancer Causes Control. 2013;24:559–565.
    1. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348:1625–1638.
    1. Aune D, Greenwood DC, Chan DS, Vieira R, Vieira AR, Navarro Rosenblatt DA, Cade JE, Burley VJ, Norat T. Body mass index, abdominal fatness and pancreatic cancer risk: a systematic review and non-linear dose-response meta-analysis of prospective studies. Ann Oncol. 2012;23:843–852.
    1. Appleby PN, Crowe FL, Bradbury KE, Travis RC, Key TJ. Mortality in vegetarians and comparable nonvegetarians in the United Kingdom. Am J Clin Nutr. 2016;103:218–230.
    1. Rohrmann S, Linseisen J, Nöthlings U, Overvad K, Egeberg R, Tjønneland A, Boutron-Ruault MC, Clavel-Chapelon F, Cottet V, Pala V, et al. Meat and fish consumption and risk of pancreatic cancer: results from the European Prospective Investigation into Cancer and Nutrition. Int J Cancer. 2013;132:617–624.
    1. Larsson SC, Wolk A. Red and processed meat consumption and risk of pancreatic cancer: meta-analysis of prospective studies. Br J Cancer. 2012;106:603–607.
    1. Arem H, Mayne ST, Sampson J, Risch H, Stolzenberg-Solomon RZ. Dietary fat intake and risk of pancreatic cancer in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Ann Epidemiol. 2013;23:571–575.
    1. Aschebrook-Kilfoy B, Cross AJ, Stolzenberg-Solomon RZ, Schatzkin A, Hollenbeck AR, Sinha R, Ward MH. Pancreatic cancer and exposure to dietary nitrate and nitrite in the NIH-AARP Diet and Health Study. Am J Epidemiol. 2011;174:305–315.
    1. Bao Y, Hu FB, Giovannucci EL, Wolpin BM, Stampfer MJ, Willett WC, Fuchs CS. Nut consumption and risk of pancreatic cancer in women. Br J Cancer. 2013;109:2911–2916.
    1. Wu L, Wang Z, Zhu J, Murad AL, Prokop LJ, Murad MH. Nut consumption and risk of cancer and type 2 diabetes: a systematic review and meta-analysis. Nutr Rev. 2015;73:409–425.
    1. Michaud DS, Vrieling A, Jiao L, Mendelsohn JB, Steplowski E, Lynch SM, Wactawski-Wende J, Arslan AA, Bas Bueno-de-Mesquita H, Fuchs CS, et al. Alcohol intake and pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium (PanScan) Cancer Causes Control. 2010;21:1213–1225.
    1. Wu QJ, Wu L, Zheng LQ, Xu X, Ji C, Gong TT. Consumption of fruit and vegetables reduces risk of pancreatic cancer: evidence from epidemiological studies. Eur J Cancer Prev. 2016;25:196–205.
    1. Maisonneuve P, Lowenfels AB. Risk factors for pancreatic cancer: a summary review of meta-analytical studies. Int J Epidemiol. 2015;44:186–198.
    1. Rosato V, Polesel J, Bosetti C, Serraino D, Negri E, La Vecchia C. Population attributable risk for pancreatic cancer in Northern Italy. Pancreas. 2015;44:216–220.
    1. Batabyal P, Vander Hoorn S, Christophi C, Nikfarjam M. Association of diabetes mellitus and pancreatic adenocarcinoma: a meta-analysis of 88 studies. Ann Surg Oncol. 2014;21:2453–2462.
    1. Haugvik SP, Hedenström P, Korsæth E, Valente R, Hayes A, Siuka D, Maisonneuve P, Gladhaug IP, Lindkvist B, Capurso G. Diabetes, smoking, alcohol use, and family history of cancer as risk factors for pancreatic neuroendocrine tumors: a systematic review and meta-analysis. Neuroendocrinology. 2015;101:133–142.
    1. Stevens RJ, Roddam AW, Beral V. Pancreatic cancer in type 1 and young-onset diabetes: systematic review and meta-analysis. Br J Cancer. 2007;96:507–509.
    1. Li D, Tang H, Hassan MM, Holly EA, Bracci PM, Silverman DT. Diabetes and risk of pancreatic cancer: a pooled analysis of three large case-control studies. Cancer Causes Control. 2011;22:189–197.
    1. Bosetti C, Rosato V, Li D, Silverman D, Petersen GM, Bracci PM, Neale RE, Muscat J, Anderson K, Gallinger S, et al. Diabetes, antidiabetic medications, and pancreatic cancer risk: an analysis from the International Pancreatic Cancer Case-Control Consortium. Ann Oncol. 2014;25:2065–2072.
    1. Chen XZ, Schöttker B, Castro FA, Chen H, Zhang Y, Holleczek B, Brenner H. Association of helicobacter pylori infection and chronic atrophic gastritis with risk of colonic, pancreatic and gastric cancer: A ten-year follow-up of the ESTHER cohort study. Oncotarget. 2016;7:17182–17193.
    1. Ekbom A, McLaughlin JK, Karlsson BM, Nyrén O, Gridley G, Adami HO, Fraumeni JF. Pancreatitis and pancreatic cancer: a population-based study. J Natl Cancer Inst. 1994;86:625–627.
    1. Kudo Y, Kamisawa T, Anjiki H, Takuma K, Egawa N. Incidence of and risk factors for developing pancreatic cancer in patients with chronic pancreatitis. Hepatogastroenterology. 2011;58:609–611.
    1. Duell EJ, Lucenteforte E, Olson SH, Bracci PM, Li D, Risch HA, Silverman DT, Ji BT, Gallinger S, Holly EA, et al. Pancreatitis and pancreatic cancer risk: a pooled analysis in the International Pancreatic Cancer Case-Control Consortium (PanC4) Ann Oncol. 2012;23:2964–2970.
    1. Lowenfels AB, Maisonneuve P, Whitcomb DC. Risk factors for cancer in hereditary pancreatitis. International Hereditary Pancreatitis Study Group. Med Clin North Am. 2000;84:565–573.
    1. Jacobs EJ, Chanock SJ, Fuchs CS, Lacroix A, McWilliams RR, Steplowski E, Stolzenberg-Solomon RZ, Arslan AA, Bueno-de-Mesquita HB, Gross M, et al. Family history of cancer and risk of pancreatic cancer: a pooled analysis from the Pancreatic Cancer Cohort Consortium (PanScan) Int J Cancer. 2010;127:1421–1428.
    1. Greer JB, Whitcomb DC, Brand RE. Genetic predisposition to pancreatic cancer: a brief review. Am J Gastroenterol. 2007;102:2564–2569.
    1. Slebos RJ, Hoppin JA, Tolbert PE, Holly EA, Brock JW, Zhang RH, Bracci PM, Foley J, Stockton P, McGregor LM, et al. K-ras and p53 in pancreatic cancer: association with medical history, histopathology, and environmental exposures in a population-based study. Cancer Epidemiol Biomarkers Prev. 2000;9:1223–1232.
    1. Shen M, Boffetta P, Olsen JH, Andersen A, Hemminki K, Pukkala E, Tracey E, Brewster DH, McBride ML, Pompe-Kirn V, et al. A pooled analysis of second primary pancreatic cancer. Am J Epidemiol. 2006;163:502–511.
    1. Hemminki K, Li X, Sundquist J, Sundquist K. Cancer risks in Crohn disease patients. Ann Oncol. 2009;20:574–580.
    1. Pericleous M, Rossi RE, Mandair D, Whyand T, Caplin ME. Nutrition and pancreatic cancer. Anticancer Res. 2014;34:9–21.
    1. Koushik A, Spiegelman D, Albanes D, Anderson KE, Bernstein L, van den Brandt PA, Bergkvist L, English DR, Freudenheim JL, Fuchs CS, et al. Intake of fruits and vegetables and risk of pancreatic cancer in a pooled analysis of 14 cohort studies. Am J Epidemiol. 2012;176:373–386.
    1. Lucenteforte E, La Vecchia C, Silverman D, Petersen GM, Bracci PM, Ji BT, Bosetti C, Li D, Gallinger S, Miller AB, et al. Alcohol consumption and pancreatic cancer: a pooled analysis in the International Pancreatic Cancer Case-Control Consortium (PanC4) Ann Oncol. 2012;23:374–382.
    1. Liu Y, Chen JQ, Xie L, Wang J, Li T, He Y, Gao Y, Qin X, Li S. Effect of aspirin and other non-steroidal anti-inflammatory drugs on prostate cancer incidence and mortality: a systematic review and meta-analysis. BMC Med. 2014;12:55.
    1. Stan SD, Singh SV, Brand RE. Chemoprevention strategies for pancreatic cancer. Nat Rev Gastroenterol Hepatol. 2010;7:347–356.
    1. Vitone LJ, Greenhalf W, Howes NR, Neoptolemos JP. Hereditary pancreatitis and secondary screening for early pancreatic cancer. Rocz Akad Med Bialymst. 2005;50:73–84.
    1. Walsh RM, Vogt DP, Henderson JM, Hirose K, Mason T, Bencsath K, Hammel J, Brown N. Management of suspected pancreatic cystic neoplasms based on cyst size. Surgery. 2008;144:677–684; discussion 684-685.
    1. Tanaka M, Fernández-del Castillo C, Adsay V, Chari S, Falconi M, Jang JY, Kimura W, Levy P, Pitman MB, Schmidt CM, et al. International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology. 2012;12:183–197.
    1. Greenhalf W, Grocock C, Harcus M, Neoptolemos J. Screening of high-risk families for pancreatic cancer. Pancreatology. 2009;9:215–222.
    1. Shin EJ, Canto MI. Pancreatic cancer screening. Gastroenterol Clin North Am. 2012;41:143–157.
    1. Cappelli G, Paladini S, D’Agata A. [Tumor markers in the diagnosis of pancreatic cancer] Tumori. 1999;85:S19–S21.
    1. Gemmel C, Eickhoff A, Helmstädter L, Riemann JF. Pancreatic cancer screening: state of the art. Expert Rev Gastroenterol Hepatol. 2009;3:89–96.
    1. Canto MI, Goggins M, Hruban RH, Petersen GM, Giardiello FM, Yeo C, Fishman EK, Brune K, Axilbund J, Griffin C, et al. Screening for early pancreatic neoplasia in high-risk individuals: a prospective controlled study. Clin Gastroenterol Hepatol. 2006;4:766–781; quiz 665.
    1. Canto MI, Goggins M, Yeo CJ, Griffin C, Axilbund JE, Brune K, Ali SZ, Jagannath S, Petersen GM, Fishman EK, et al. Screening for pancreatic neoplasia in high-risk individuals: an EUS-based approach. Clin Gastroenterol Hepatol. 2004;2:606–621.
    1. James TA, Gibbs JF. Pancreatic cancer screening: identifying premalignant disease. Future Oncol. 2005;1:191–195.

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