Pancreatic cancer is the fourth leading cause of cancer death in the United States. Every year, 30,000 to 40,000 people living in this country die of the disease. Perhaps even more alarming, the incidence of pancreatic cancer appears to be increasing.

Five percent to ten percent of pancreatic cancer cases are hereditary; the risk of pancreatic cancer is increased three-fold if one first-degree relative is affected. Having multiple affected family members increases the risk even more. In high-risk families, some members may have a fifty-fifty chance of developing the disease. At present, almost all symptomatic pancreatic cancer is advanced and incurable when diagnosed. In hereditary pancreatic cancer, we have already shown that pre-cancer or early cancer diagnosed while asymptomatic is curable.

Given the risk factors, early detection is essential. A team of doctors at the UW has developed a multi-disciplinary surveillance program for the early detection of pancreatic cancer and its precursors in patients with a familial predisposition for the disease. This surveillance program is the first of its kind in the world. The approach requires the expertise and dedication of specialists who are trained in pathology, endoscopy, and surgery of the pancreas. Specialists at the UW are among only a handful of physicians worldwide with the expertise and experience to identify patients who have pancreatic pre-cancer and whose condition warrants surgical intervention to prevent cancer from developing.

UW researchers are advancing the frontiers of clinical care. The genes that cause pancreatic cancer are being sought, an effort that will help define more clearly which family members are at risk. When a genetic test to diagnose hereditary pancreatic cancer is discovered, it may also prove useful in diagnosing the more common non-hereditary types of the disease. Epidemiologic studies at the UW have uncovered risk factors, such as smoking and exposure to dry cleaning fluids, which can dramatically influence the cancer risk of patients who have a positive family history. Similar environmental factors may be found in the more common non-familial pancreatic cancers. Other UW faculty are conducting basic science research aimed at refining early diagnosis, prevention, and treatment for all forms of pancreatic cancer.