Ductal Adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is the most prevalent neoplastic disease of the pancreas accounting for more than 90% of all pancreatic malignancies. To date, PDAC is the fourth most frequent cause of cancer-related deaths worldwide with a 5-year overall survival of less than 8%. The incidence of PDAC is expected to rise further in the future, and projections indicate a more than two-fold increase in the number of cases within the next ten years, both in terms of new diagnoses as well as in terms of PDAC-related deaths in the U.S. as well as in European countries. A particular reason for this – apart from the general aging of our society – is the evident implication of obesity and type 2 diabetes, two emerging public health challenges, in PDAC etiology. Life style habits, including alcohol and tobacco abuse, which are well-known to increase the risk for several other types of cancer, such as lung cancer and squamous cell carcinomas of the head and neck region, also appear to be involved in PDAC development. Finally, for a subgroup of approximately 5-6% of all PDAC patients, genetic predispositions, such as germline mutations in the genes BRCA1/2, ATM, MLH1, TP53, or CDKN2A, represent further risk factors.