review article

Pancreatic ductal adenocarcinoma is the most lethal common cancer because it is usually diagnosed at an advanced stage and is resistant to therapy. In this article, we review current understanding of the biology and treatment of pancreatic adenocarcinoma. Epidemiol o gy a nd R isk Fac t or s Pancreatic adenocarcinoma is rarely diagnosed in persons younger than 40 years of age, and the median age at diagnosis is 71 years. Worldwide, the incidence of all types of pancreatic cancer (85 % of which are adenocarcinomas) ranges from 1 to 10 cases per 100,000 people, is generally higher in developed countries and among men, and has remained stable for the past 30 years relative to the incidence of other common solid tumors.1 It is the eighth leading cause of death from cancer in men and the ninth leading cause of death from cancer in women throughout the world. In the United States this year, pancreatic cancer is expected to develop in 46,000 people, and 40,000 people are expected to die from it.2 The risk factors and established genetic syndromes associated with pancreatic adenocarcinoma are shown in Table 1. Although it is estimated that 5 to 10 % of pancreatic cancers have an inherited component, the genetic basis for familial ag