| Early-stage diagnosis is considered essential for improving the prognosis of patients with pancreatic cancer (PC). A recent Japanese study reported that many cases of stage 0 and I PC exhibit indirect findings, such as dilatation of the main pancreatic duct (MPD). Risk factors such as diabetes mellitus, and intraductal papillary mucinous neoplasm are the most likely. 30% of cases experience symptoms, with about 20% of asymptomatic cases being diagnosed during medical health check-ups. Tumor marker elevation is rarely detected. Initial findings such as MPD dilatation detected by US are crucial. EUS and MRI have favorable visibility in identifying MPD stenosis. Additionally, CT can detect localized pancreatic atrophy or focal fatty changes in parenchyma in 30-64%. In many cases of stage 0 PC, focal pancreatitis, fibrosis, and fatty infiltration observed histopathologically around the PC lesion may reflect imaging findings by CT and EUS. ERCP and its associated pancreatic juice cytology including serial pancreatic juice aspiration cytologic examination may be crucial in diagnosing early-stage PC. In 2007, the Onomichi Medical Association initiated a social program wherein PC specialists from medical centers collaborated with general practitioners to improve early PC diagnosis. This program has led to an increase in early-stage diagnoses, improved a five-year survival rate of about 20% in Onomichi region. The development of these programs utilizing collaboration between medical institutions is expected to further contribute to improving PC prognosis. |
