Pancreatic ductal adenocarcinoma is the fifth leading cause of cancer death in the Western hemisphere. The age adjusted incidence rates range from 3.1 to 20.8 deaths per 100,000 in developed countries [1-3], with a peak incidence in patients between 60 and 80 years old. Because of the very low rate of survival, the incidence and mortality rates are similar.
Factors associated with an increased risk of pancreatic cancer include smoking, chronic pancreatitis, diabetes, prior gastric surgery, and exposure to radiation or chemicals such as chlorinated hydrocarbon solvents [4-6]. A number of syndromes are identified with an increased incidence of pancreatic cancer, including familial atypical multiple-mole melanoma syndrome, hereditary nonpolyposis colorectal cancer, hereditary pancreatitis, Peutz-Jeghers syndrome, and hereditary breast-ovarian cancer syndrome [7]. Genetic point mutations, amplifications, or overexpression of oncogenes, such as KRAS, HER/2-neu, [8-11], and alterations of tumor suppressor genes, such as p16 and TP53 [12, 13], have also been associated as risk factors.