Toward Timely Diagnosis of Pancreatic Cancer: Revolutionizing Early Detection Through Genomics, Artificial Intelligence, and Noninvasive Biomarkers.

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most aggressive cancers, typically diagnosed at an advanced stage due to its subtle and often absent early symptoms. Despite representing only 3% of new cancer cases, it is projected to become the second leading cause of cancer-related deaths by 2030. Currently, early diagnosis remains a significant challenge, and survival rates remain poor due to the lack of effective screening tools. We conducted a comprehensive literature review to explore the most recent advances in PDAC detection, focusing on novel biomarkers, liquid biopsies, artificial intelligence (AI)-enhanced imaging, and non-invasive surveillance strategies. We examined the role of circulating tumor DNA (ctDNA), microRNAs, and volatile organic compounds (VOCs) as diagnostic tools, alongside the integration of advanced imaging modalities like MRI, EUS, and MRCP in high-risk individuals, including those with hereditary cancer syndromes. Emerging technologies, such as AI-driven imaging and liquid biopsy, have shown promising improvements in detecting PDAC at earlier, potentially resectable stages. Surveillance strategies for high-risk populations, including BRCA1/2 mutation carriers and individuals with Lynch syndrome, have demonstrated increased detection of Stage I PDAC, offering a significant opportunity for curative intervention. AI and machine learning techniques are also enhancing the sensitivity and specificity of imaging, providing a new frontier in early-stage diagnosis. The integration of molecular diagnostics, advanced imaging technologies, and AI may enable a paradigm shift in PDAC detection, transitioning from late to early-stage diagnosis and potentially improving survival rates. However, further clinical validation and standardization of these technologies are essential to ensure their widespread clinical adoption. The future of PDAC detection lies in a multimodal, personalized approach, optimizing diagnostic accuracy and early intervention for high-risk individuals.