Pancreatic Cancer Prevention and Earlier Detection: Risk Enrichment, Biomarkers and Implementation

Pancreatic cancer remains one of the most lethal malignancies, largely because most cases are diagnosed at an advanced, incurable stage. Population-wide screening is not currently appropriate for people at average risk, so progress against this disease depends on identifying individuals and groups whose risk is sufficiently enriched to justify targeted assessment, surveillance, or preventive intervention. Clinical signals such as new-onset or worsening diabetes, pancreatic cysts, and chronic pancreatitis, alongside inherited susceptibility and population-derived risk-prediction models built on linked health records, primary-care data, and registries, are converging to make earlier identification a realistic goal rather than an aspiration. Yet these signals only matter if they can be connected to diagnostic pathways that clinicians and health systems can actually act on.This Research Topic (article collection) aims to bring together research that links risk identification to real-world clinical action: from defining who is at enriched risk, to validating the biomarkers and diagnostic tools that can be deployed within that risk-based pathway, to demonstrating that the resulting strategies improve outcomes without introducing unacceptable harms or costs. We are particularly interested in work that evaluates biomarkers, imaging, or endoscopic approaches as part of a defined surveillance or diagnostic strategy rather than as isolated technologies, and in studies that confront the practical barriers to implementation, including overdiagnosis, false positives, cost-effectiveness, acceptability, and equitable access to genetic testing and surveillance. To capture the breadth and depth of current research, we welcome articles including but not limited to the following topics:- Clinical risk signals for pancreatic cancer, including new-onset or worsening diabetes, pancreatic cysts, and chronic pancreatitis- Familial and germline susceptibility, genetic risk stratification, and equitable access to genetic counseling and testing- Population-derived risk-prediction models using linked health records, primary-care data, registries, and electronic health records- Blood-, urine-, and extracellular-vesicle-based biomarkers evaluated within a defined risk-based surveillance or diagnostic pathway- Imaging, endoscopy, and health-checkup or surveillance strategies assessed as part of an integrated diagnostic pathway rather than as standalone tools- Implementation questions including prospective validation, stage shift, overdiagnosis, cost-effectiveness, patient and clinician acceptability, and equitable access across diverse populations and health systemsWe invite researchers, clinicians, and health-system leaders working across any part of this risk-to-implementation pathway to contribute to this collection. Real-world studies, prospective validation cohorts, modeling and health-economic analyses, and implementation-science research are especially welcome. We invite you to submit Original Research, Systematic Review, Perspective, and Brief Research Report articles that advance prevention-oriented, clinically actionable approaches to earlier pancreatic cancer detection.Please note: manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent clinical or patient cohort, or biological validation in vitro or in vivo, which are not based on public databases) are not suitable for publication in this journal. Topic editors: Tamas Gonda, Daniel C Beachler, Carlos H Chan, Barbara Kenner Source: https://www.frontiersin.org/research-topics/86088/pancreatic-cancer-prevention-and-earlier-detection-risk-enrichment-biomarkers-and-implementation