title: Limitations in improving detection of pancreatic adenocarcinoma.
abstract: OBJECTIVE
  To review the current trends in pancreatic cancer research and propose alternatives for an earlier diagnosis.
  
  
  METHODS
  A search was conducted using the PubMed and Scielo electronic databases to find statistics related to the incidence of pancreatic cancer.
  
  
  RESULTS
  Pancreatic cancer is the fourth most common cause of cancer mortality in the USA; in Colombia the incidence of this neoplasia is 4.5 per 100,000 individuals; and in Peru, amongst digestive diseases, it is the fifth most common cause. In Brazil and Chile this cancer has increased in incidence, while in Mexico, it has decreased in terms of the relative percentage of gastrointestinal cancers from 1976 to 2003. Chronic pancreatitis, cigarette smoking, diabetes, obesity and dietary mutagen exposure are the most consistent risk factors implicated in the development of pancreatic cancer; however, the genetic and molecular changes underlying the epidemiological association between these factors and pancreatic cancer remain largely unknown, and only 5-10% are hereditary in nature.
  
  
  CONCLUSIONS
  The prognosis for pancreatic cancer has not changed substantially for at least the last 20 years. The most useful tumor marker for pancreatic adenocarcinoma is still the carbohydrate antigen 19-9 (CA19-9). Currently, a multimodal-screening approach of endoscopic ultrasound, computed tomography and endoscopic retrograde cholangiopancreatography are the most effective methods to detect pancreatic cancer in high-risk patients. Future options for early detection of this malignancy are focused on new molecular markers, telomerase enzyme, receptor-targeted imaging using multifunctional nanoparticles, detection of glycan changes and epigenetics.
authors.affiliation: Medical Research Center (CICMED), Autonomous University of the State of Mexico (UAEMex), Materno Perinatal Hospital of the State of Mexico, Toluca, Mexico. mezh_74@yahoo.com
authors.forename: Hugo
authors.initials: H
authors.lastname: Mendieta Zerón
authors.forename: Jesús Rey
authors.initials: JR
authors.lastname: García Flores
authors.forename: Martha Liliana
authors.initials: ML
authors.lastname: Romero Prieto
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy; D003952:Diagnostic Imaging; D006801:Humans; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy; D012307:Risk Factors