Early detection of pancreatic cancer

I read the article by Tanaka et al.1 that was recently published in Pancreas with interest. Although their report is preliminary, the authors have made an important point that I hope will be confirmed in a more extensive group of patients: that periodic screening abdominal ultrasound may be useful for early detection of pancreatic cancer. In this connection I would like to point out that in a recent multicenter study of nonfunctioning pancreatic endocrine tumors2 we showed that in 64 (34.8%) of the 184 patients studied the tumor was discovered incidentally by abdominal ultrasound performed as part of a routine check-up of asymptomatic individuals. Patients in the group of 64 had significantly fewer metastases as well as significantly greater survival as compared with the 120 symptomatic patients (p= 0.0043). From these results we concluded that abdominal pancreatic ultrasound should be performed every 1 to 2 years in all individuals over the age of fifty, especially in view of the fact that it is such a simple and unexpensive technique. We all know that early diagnosis is still our best defense against tumors, so if this can be done with a test as simple and cheap as ultrasound, there is no good reason not to do it.