Do early symptoms of pancreatic cancer exist that can allow an earlier diagnosis?

Diagnosis of pancreatic cancer is made late, and prognosis remains extremel y poor. This study was carried out to investigate whether symptoms exist be fore pain or jaundice that could suggest pancreatic cancer and favor earlie r diagnosis. The study involved 305 patients with confirmed pancreatic canc er and 305 controls. All subjects were interviewed personally at least twic e about their clinical history; pancreatic cancer patients were asked about any disturbances before abdominal pain or jaundice. Of the 305 pancreatic cancer patients, 151 (49.5%) had some prior disturbances, 108 (35.4%) 6 mon ths or less before pain or jaundice and 43 (14.1%) more than 6 months befor e. Among the latter, 14 (4.6% of all patients) had had anorexia and/or earl y satiety and/or asthenia (7-20 months before pain or jaundice), 11 (3.6%) had disgust for coffee and/or smoking and/or wine (7-20 months before), 14 (4.6%) had diabetes (7-24 months before), and four (1.3%) had acute pancrea titis (8-26 months before). Among the controls, the only reports of these s ymptoms were two (0.7%) cases of asthenia (4 and 6 years earlier), 22 (7.2% ) cases of diabetes (of which only two 10.7%] were diagnosed 7-24 months be fore the interview), and one (0.33%) case of acute pancreatitis (10 years e arlier). Apart from acute pancreatitis, all the other differences between p atients and controls were statistically significant. In approximately 15% o f patients, disturbances existed more than 6 months before pain or jaundice , which, although not specific, could raise suspicion of the possibility of pancreatic cancer. These disturbances could represent the one current oppo rtunity for an earlier diagnosis in a significant minority of pancreatic ca ncer patients.