Molecular pathogenesis of pancreatic ductal adenocarcinoma and clinical implications

Pancreatic ductal adenocarcinoma (PDAC) is a significant cause of cancer de ath worldwide. PDAC is also one of the best-studied cancers with regard to molecular pathogenesis. The chief risk factors associated with PDAC are smo king and pancreatitis, in addition genetic predisposition seems to play a m ajor role. This genetic predisposition may in some cases be indirect, for e xample via the elevated risk of pancreatitis seen in patients with heredita ry pancreatitis (HP). The elucidation of the molecular causes of PDAC has e nabled the provision of secondary screening for PDAC in conditions such as HP. This review is concerned with the molecular pathogenesis of PDAC and th e application of this basic scientific understanding into state-of-the-art clinical practice. (C) 2001 Elsevier Science Ltd. All rights reserved.