# Pancreatic cancer early detection biomarkers for high-risk individuals: insights from the PRECEDE consortium

Source: https://onco.cc/key-papers/paper-worthington-precede-early-detection-biomarkers-ijc-2026/  
OnCo record `paper-worthington-precede-early-detection-biomarkers-ijc-2026` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A review from the PRECEDE consortium of what might catch pancreatic cancer early in people at high risk: imaging remains the backbone, cyst fluid and pancreatic juice add specificity, and blood, microbiome and multi-omic markers are still research because early lesions shed too little to measure.

## Summary

Efforts in early detection have centred on imaging features and liquid biopsy biomarkers able to detect pancreatic ductal adenocarcinoma and its high-grade precursors before symptoms in people at elevated risk. Classical imaging-based surveillance aligned with current guidelines forms the foundation, while organ-specific fluid analyses such as cyst fluid and pancreatic juice offer complementary tools with enhanced specificity. Advances in radiomics, liquid biopsy, microbiome and multi-omics profiling are expanding the field, but precursor lesions are difficult to diagnose non-invasively, are often not visible radiologically or endosonographically and cannot be definitively graded before resection; early-stage neoplasias release low levels of many biomarkers and thresholds defining malignant transformation remain poorly established. The PRECEDE international cohort study of high-risk individuals was designed to discover and validate diagnostic biomarkers under the PROBE study design.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Journal: International Journal of Cancer
- Year: 2026
- DOI: 10.1002/ijc.70592
- Authors: Worthington C, Raitses-Gurevich M, Innamorati G, et al.
- Findings: Imaging surveillance remains the foundation; cyst fluid and pancreatic juice add specificity.; Early lesions shed too little for current blood markers and transformation thresholds are unestablished.
- What it means: The current honest statement of where early detection stands: no blood test is ready, and the research is about finding the threshold at which to operate.
- Caveats: Review; the PRECEDE cohort's own biomarker results are not yet reported.; High-risk individuals only, not population screening.

## Sources

- Worthington et al., Int J Cancer 2026: early detection biomarkers for high-risk individuals, PRECEDE: https://doi.org/10.1002/ijc.70592
- PubMed: https://pubmed.ncbi.nlm.nih.gov/42298760/

## Connected records

- cancers: [Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors](https://onco.cc/cancers/ipmn-cystic-precursors/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- technologies: [DNA methylation profiling](https://onco.cc/technologies/methylation-profiling/), [High-risk pancreatic surveillance (CAPS / PRECEDE)](https://onco.cc/technologies/pancreatic-surveillance/), [Liquid biopsy (ctDNA)](https://onco.cc/technologies/liquid-biopsy/), [Multi-cancer early detection (MCED)](https://onco.cc/technologies/mced/), [Proteomics & phosphoproteomics](https://onco.cc/technologies/proteomics/)
- institutions: [Laura and Isaac Perlmutter Cancer Center at NYU Langone Health](https://onco.cc/institutions/nyu-perlmutter/), [Sheba Medical Center](https://onco.cc/institutions/sheba/)
- terms: [CA 19-9](https://onco.cc/terms/ca19-9/), [Cell-free DNA (cfDNA)](https://onco.cc/terms/cfdna/)
- trials: [PRECEDE](https://onco.cc/trials/precede/)
- people: [Diane M. Simeone](https://onco.cc/people/diane-simeone/), [Talia Golan](https://onco.cc/people/talia-golan/)

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