Enhancing Early Detection of Pancreatic Cancer in Genetically Predisposed Individuals: Integrating Advanced Imaging Modalities with Emerging Biomarkers and Liquid Biopsy.

Purpose: Pancreatic cancer is one of the most lethal malignancies, with a five-year survival rate rarely exceeding 10%. Due to its asymptomatic onset, it is frequently diagnosed at an advanced and often inoperable stage. This review assesses current strategies for early detection, including genomic testing, advanced imaging technologies, and biomarker-based platforms, with a focus on their clinical utility and integration into surveillance protocols. Methods: This narrative review synthesizes findings from published literature on germline genetic testing (GGT), imaging modalities such as endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI), and the latest advancements in biomarker discovery and molecular diagnostics for early pancreatic cancer detection. International guidelines and emerging evidence were assessed to explore their clinical implementation and challenges. Results: Although EUS and MRI show promise for detecting early pancreatic lesions, both require specialized expertise and are limited by accessibility and cost. Emerging blood-based biomarkers and molecular platforms, however, may offer a more scalable, non-invasive alternative for detecting pancreatic cancer at earlier, treatable stages. Conclusion: Early detection of pancreatic cancer is pivotal to improving survival outcomes. While imaging techniques and genetic screening have enhanced risk stratification and early diagnosis in high-risk populations, novel biomarker and molecular testing platforms offer an accessible and scalable solution. Future efforts should focus on validating these assays in large-scale prospective cohorts and integrating them into screening protocols, particularly for individuals with genetic susceptibility.