Diagnosis of
pancreatic cancer is made late, and prognosis remains extremely poor. This study was carried out to investigate whether symptoms exist before
pain or
jaundice that could suggest
pancreatic cancer and favor earlier diagnosis. The study involved 305 patients with confirmed
pancreatic cancer and 305 controls. All subjects were interviewed personally at least twice about their clinical history;
pancreatic cancer patients were asked about any disturbances before
abdominal pain or
jaundice. Of the 305
pancreatic cancer patients, 151 (49.5%) had some prior disturbances, 108 (35.4%) 6 months or less before
pain or
jaundice and 43 (14.1%) more than 6 months before. Among the latter, 14 (4.6% of all patients) had had
anorexia and/or early satiety and/or
asthenia (7-20 months before
pain or
jaundice), 11 (3.6%) had disgust for
coffee and/or smoking and/or wine (7-20 months before), 14 (4.6%) had diabetes (7-24 months before), and four (1.3%) had
acute pancreatitis (8-26 months before). Among the controls, the only reports of these symptoms were two (0.7%) cases of
asthenia (4 and 6 years earlier), 22 (7.2%) cases of diabetes (of which only two [0.7%] were diagnosed 7-24 months before the interview), and one (0.33%) case of
acute pancreatitis (10 years earlier). Apart from
acute pancreatitis, all the other differences between patients and controls were statistically significant. In approximately 15% of patients, disturbances existed more than 6 months before
pain or
jaundice, which, although not specific, could raise suspicion of the possibility of
pancreatic cancer. These disturbances could represent the one current opportunity for an earlier diagnosis in a significant minority of
pancreatic cancer patients.