Early diagnosis of pancreatic cancer: current diagnostic methods and the role of primary care physicians in improving outcomes - a narrative review

Abstract

Pancreatic cancer is one of the most aggressive malignancies and a leading cause of cancer-related mortality worldwide. Prognosis remains poor due to late diagnosis, as early-stage disease is usually asymptomatic or presents with non-specific symptoms, and the lack of effective screening results in most patients being diagnosed at an advanced stage. This review evaluates challenges in pancreatic cancer diagnosis, summarizes available diagnostic methods, and highlights the role of primary care physicians in early detection. Evidence published between 2015 and 2026 was analyzed. A structured literature search was conducted using PubMed and Google Scholar. Search terms included "pancreatic cancer", "early diagnosis", "screening", "biomarkers", "imaging", "liquid biopsy", "circulating tumor DNA", and "artificial intelligence". Original studies, reviews, and clinical guidelines were included. CT remains the primary imaging modality, though sensitivity decreases for small lesions. Endoscopic ultrasound improves detection and enables tissue sampling. CA 19-9 has limited early diagnostic value. Liquid biopsy methods show promise but remain under validation. Radiomics and AI may enhance detection of subtle imaging features. Primary care physicians are essential for recognizing suspicious symptoms and ensuring timely referral. Early diagnosis remains challenging due to non-specific symptoms, limited screening, and diagnostic shortcomings. A multimodal approach combining imaging, biomarkers, and emerging technologies is needed. Greater awareness among primary care physicians and continued development of liquid biopsy and AI tools may improve outcomes.