Endoscopic ultrasound and early diagnosis of pancreatic cancer

Incidence of pancreatic cancer has increased, but prognosis remains poor. Curative treatment is dependent on early diagnosis. Endoscopic ultrasound (EUS) has been described as highly sensitive and accurate in staging, superior to other imaging modalities in early publications. With rapid advances in technology, other imaging techniques have reached better results. EUS still has the highest accuracy in assessing tumor size and lymph node involvement. For assessment of tumor respectability, a combination of a computed tomography (CT) scan and EUS seems to be the procedure with the highest accuracy. Promising new techniques might improve the diagnostic yield of EUS. But there are several reasons for failure, and EUS shows a high interobserver variety. Nevertheless, EUS proved to have a high negative predictive value. Screening for pancreatic cancer and its precursor lesions in the general population is not feasible, but high-risk subpopulations could be suitable targets for screening, preferably with an EUS- and CT-based protocol.