Pancreatic cancer--low survival rates

Cancers of the pancreas are identified in 11 800 to 13 500 patients each year in Germany (1). The mean age at disease onset is 68 years in men and 70 years in women. For some years, women have been observed to develop the disease more frequently than men (1). The growing incidence of pancreatic cancer in the industrialized countries is attributed to overweight (2), increasing age, smoking (4), and chronic alcohol consumption (4). Epidemiological studies have shown smoking to be the cause in about 30% of cases of ductal pancreatic cancer (3); pancreatic diseases with a markedly elevated risk of malignancy – besides the genetically determined syndromes with high pancreatic carcinoma penetrance (5) – are hereditary chronic pancreatitis with up to 40% malignancy (6), chronic alcoholic pancreatitis with 4% to 6 % malignancy (7), and cystic neoplasms with a malignant transformation rate of 20% to 70% (8). Pancreatic cancer is still incurable for more than 95% of patients (9). In preparation for exercising the function of expert (Beger), and as a member of the Surgical Treatment Working Group for drafting of the S3 guidelines of the German Society of Digestive and Metabolic Diseases (DGVS)/ of the Scientific Medical Societies in Germany (AWMF) (Rau), the authors conducted a selective literature review based on their clinical and scientific experience.