Abstract

Earlier diagnosis is critical to improving survival in pancreatic ductal adenocarcinoma by making intervention strategies successful. However, positive identification of early tumours is made more challenging by pre-malignant conditions from which cancers arise, but where the transformation rate is low, and many biomarker studies utilising retrospective cohorts in late-stage disease. Biomarker panels which identify early cancers and stratify precursor lesions that need treatment from those that do not would be expected to extend life and reduce unnecessary interventions. In recent years, a variety of novel biomarkers from body fluids, including blood, urine, saliva, breath, pancreatic juice and stool, have been reported. With advances in high throughput techniques and “omics” analyses, various circulating biomarkers, such as circulating tumour cells, metabolites, cell-free DNA, noncoding RNA, and exosomes, have been widely studied and show promising diagnostic value. Collaborative large-scale studies are required to test the clinical validity and applicability of potential biomarkers in ‘at-risk’ populations in primary and secondary care.