Pancreatic cancer may be difficult to find early. It usually doesn’t cause clear symptoms at first, and the pancreas is located deep in the body, making tumors challenging to detect with routine exams. As a result, about 80% of pancreatic cancers are diagnosed after the disease has already advanced, when surgery — the only potential effective treatment — is no longer an option.
There’s growing hope for earlier diagnosis, however, through targeted screening for people who are considered at high risk for developing pancreatic cancer — such as those with a strong family history or certain genetic conditions. In some studies, screening has identified cancers at more treatable, resectable stages, offering a better chance for effective treatment and improved outcomes.
With expert insights from James Lin, M.D., gastroenterologist at City of Hope® Cancer Center Duarte, this article covers:
- What is pancreatic cancer screening?
- Is there a pancreatic cancer screening test?
- Benefits of screening
- Who qualifies for screening?
- Pancreatic cancer genetic testing
- What the results mean
If you or a loved one is concerned about possible signs or symptoms of cancer and would like an initial appointment or a second opinion, call us 24/7 at 877-460-4673.
What Is Pancreatic Cancer Screening?
“The risk of pancreatic cancer is low for most people,” Dr. Lin says. “That’s why organizations like the United States Preventive Services Task Force (USPSTF) don’t recommend routine screening for the general population, as they do for breast or colorectal cancer.”
For people at higher risk, however, screening may help detect cancer earlier.
“Screening typically involves advanced imaging each year,” explains Dr. Lin, who has performed pancreatic cancer screening in the Los Angeles area for more than 10 years. “We often alternate between magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS) to get the most complete view of the pancreas.”
MRCP and EUS: A Closer Look
MRCP: This is a noninvasive scan that uses MRI technology to create detailed images of the pancreas and bile ducts — without radiation.
EUS: This is a minimally invasive procedure that uses a thin, flexible tube with an ultrasound device to closely examine the pancreas from inside the body. If needed, doctors can take a small tissue sample for further testing.
For a small number of people who develop diabetes after age 50, their diabetes is an early indicator of pancreatic cancer. “Because of this, we also monitor blood sugar and hemoglobin A1c (HbA1c) levels in high-risk patients as part of ongoing surveillance,” Dr. Lin notes.
Is There a Pancreatic Cancer Screening Test?
No, there is no single, standard screening test for pancreatic cancer.
Instead, doctors rely on advanced imaging tools, including MRCP and EUS, especially for people at elevated risk. These techniques provide detailed images of the pancreas and surrounding structures, helping the care team look for early changes or signs of cancer.
Research shows that using MRCP and EUS together may give doctors a clearer picture of a person’s current risk and help detect pancreatic cancer at earlier, more treatable stages in high-risk individuals.
Benefits of Screening
While pancreatic cancer screening isn’t for everyone, it may offer important benefits for people at higher risk.
Screening may help find pancreatic cancer earlier, even before symptoms begin. When cancer is detected at an earlier stage, more treatment options — like surgery — may be possible, potentially improving outcomes.
Screening can also help identify changes in the pancreas over time, giving your care team a more informed profile of your personal risk and allowing them to act immediately if something concerning appears.
Dr. Lin emphasizes that choosing whether to undergo pancreatic cancer screening is a shared decision-making process between patient and physician.
“Screening isn’t one-size-fits-all — it starts with knowing your risk and having the right plan in place,” he says.
For those with a strong family history or certain genetic conditions, screening may be a proactive step in disease detection.
Who Qualifies for Pancreatic Cancer Screening?
According to National Comprehensive Cancer Network (NCCN) guidelines, pancreatic cancer screening is recommended for those at higher risk due to family history or genetics, not for the general population.
People may qualify for targeted screening if they have the following risks.
Certain inherited (genetic) conditions: People may be eligible — even without a family history — if they carry specific gene mutations related to higher pancreatic cancer risk, including:
- STK11 (Peutz-Jeghers syndrome)
- CDKN2A
- ATM or BRCA2
A genetic mutation and a family history of pancreatic cancer: Screening may be recommended for individuals who have one of the following gene mutations plus at least one close relative with pancreatic cancer:
- BRCA1
- PALB2
- MLH1, MSH2, MSH6, EPCAM (Lynch syndrome genes)
- TP53
Hereditary pancreatitis
People with certain gene mutations like PRSS1 or SPNK1 and a history of pancreatitis may qualify for screening.
For many high-risk individuals, pancreatic cancer screening begins at age 50, though other factors like family history may influence the age when pancreatic cancer screening may begin. It’s important for individuals to speak with their doctor or genetic counselor about whether screening is right for them.
Dr. Lin also encourages individuals to seek an oncology center with expertise in pancreatic cancer screening and surveillance.
Pancreatic Cancer Genetic Testing
Because NCCN and other pancreatic cancer screening guidelines focus on genetic risk, it’s natural to wonder how someone would even know if he or she has one of these inherited conditions.
Most people find out through genetic counseling and testing, especially if they have:
- A family history of pancreatic or related cancers
- A known genetic mutation in the family
- Multiple relatives with cancer
A genetic counselor reviews patients’ personal and family history to determine if testing makes sense for them.
The testing itself is usually straightforward and involves:
- Meeting with a genetic counselor to discuss individual risks and options
- Collection of a small sample of blood or saliva
- DNA analysis to look for inherited gene changes linked to cancer risk
Once results are available, the individual’s care team explains what they mean and whether screening is recommended.
“At City of Hope, all patients with pancreatic cancer get DNA testing as standard of care,” Dr. Lin notes. “This helps us understand the genetic changes behind a person’s cancer, so we can better personalize treatment and identify risks for family members.”
What the Results Mean
Pancreatic cancer screening results and recommendations typically fall into one of the following categories, according to the National Pancreatic Cancer Foundation.
Normal (no concerns): No signs of cancer or abnormalities; continue regular screening, often once a year.
Indeterminate (unclear): Small changes, like cysts, that aren’t clearly harmful; regular follow-up, such as repeat imaging in three to six months.
Suspicious (concerning): Areas that could be cancer or precancer; further testing right away.
“Screening is about staying a step ahead,” Dr. Lin says. “If your screening reveals something concerning, it doesn’t necessarily mean cancer, but it does mean we will move with urgency to learn more.”
Next steps may include:
- Additional imaging and/or lab tests
- A biopsy
- Review by multidisciplinary experts
If you or a loved one is concerned about possible signs or symptoms of cancer and would like an initial appointment or a second opinion, call us 24/7 at 877-460-4673.
References
- National Library of Medicine. Screening of pancreatic cancer: target population, optimal timing and how, November 5, 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC9793126/
- Facing Our Risk of Cancer Empowered. Pancreatic cancer screening guidelines, December 14, 2025.
https://www.facingourrisk.org/info/risk-management-and-treatment/screening-and-risk-reduction/by-cancer-type/pancreatic/screening - Journal of the National Comprehensive Cancer Network. NCCN Guidelines® insights: genetic/familial high-risk assessment: breast, ovarian, pancreatic and prostate, version 2.2026, February 2026.
https://doi.org/10.6004/jnccn.2026.0007