The surgeon’s view

Abstract

Pancreatic cancer remains a deadly disease in which the incidence and mortality are identical. Few patients survive, and the long-term surgical survivors are prone to recurrence, even 10–15 years later. The incidence of pancreatic cancer has remained static for the last decade with male and female incidence being similar; approximately 10 new cases occur per 100 000 population per annum. The recent trend has been for the disease to occur in older age groups and now in the UK 50% of patients are over 75 years of age. Risk factors are few and the aetiology appears multifactorial; smoking appears the most important, with chronic pancreatitis, hereditary predisposition, diabetes and carcinogens being of importance. Approximately 90% of tumours are ductal carcinomas with the remaining 10% being a wide range of different tumour types with a remarkably variable prognosis. The importance of defining the histology is probably of greater importance in pancreatic cancer than in most other tumours. Characteristically, tumours present late.