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A review from the PRECEDE consortium of what might catch pancreatic cancer early in people at high risk: imaging remains the backbone, cyst fluid and pancreatic juice add specificity, and blood, microbiome and multi-omic markers are still research because early lesions shed too little to measure.
Efforts in early detection have centred on imaging features and liquid biopsy biomarkers able to detect pancreatic ductal adenocarcinoma and its high-grade precursors before symptoms in people at elevated risk. Classical imaging-based surveillance aligned with current guidelines forms the foundation, while organ-specific fluid analyses such as cyst fluid and pancreatic juice offer complementary tools with enhanced specificity. Advances in radiomics, liquid biopsy, microbiome and multi-omics profiling are expanding the field, but precursor lesions are difficult to diagnose non-invasively, are often not visible radiologically or endosonographically and cannot be definitively graded before resection; early-stage neoplasias release low levels of many biomarkers and thresholds defining malignant transformation remain poorly established. The PRECEDE international cohort study of high-risk individuals was designed to discover and validate diagnostic biomarkers under the PROBE study design.
The current honest statement of where early detection stands: no blood test is ready, and the research is about finding the threshold at which to operate.
Shares Diane M. Simeone, PRECEDE, Laura and Isaac Perlmutter Cancer Center at NYU Langone Health, High-risk pancreatic surveillance (CAPS / PRECEDE).
Shares CA 19-9, Proteomics & phosphoproteomics, Cell-free DNA (cfDNA), Multi-cancer early detection (MCED).
Shares Multi-cancer early detection (MCED), DNA methylation profiling, Liquid biopsy (ctDNA), Pancreatic ductal adenocarcinoma.
Shares CA 19-9, High-risk pancreatic surveillance (CAPS / PRECEDE), Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Multi-cancer early detection (MCED).
Shares Cell-free DNA (cfDNA), Multi-cancer early detection (MCED), DNA methylation profiling, Liquid biopsy (ctDNA).
Shares CA 19-9, High-risk pancreatic surveillance (CAPS / PRECEDE), Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Multi-cancer early detection (MCED).
Shares Diane M. Simeone, PRECEDE, High-risk pancreatic surveillance (CAPS / PRECEDE), Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors.
Shares Proteomics & phosphoproteomics, Cell-free DNA (cfDNA), Multi-cancer early detection (MCED), Liquid biopsy (ctDNA).