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PDAC (Pancreatic Ductal Adenocarcinoma) will soon become the second leading cause of cancer-related death in Western societies. Europe has the highest burden of PDAC in the world, with 150 000 new cases in 2018 and 95 000 deaths/year and worldwide half a million deaths (Sung et al., 2021). Moreover, PDAC has the lowest survival of all cancers in Europe (median survival time 4.6 months, with patients losing 98% of their healthy life expectancy).

The biggest challenge in the management of PDAC is the inability to diagnose it in time, especially in patient groups where PDAC has not yet developed, such as individuals at risk (IAR) and patients with preneoplastic cystic lesions in the pancreas (intraductal papillary mucinous neoplasia or IMPN). Studies on biomarkers in early pancreatic cancer, especially in the at-risk groups (IAR, IPMN), are promising but have not yet produced any tangible results for clinical diagnostics. Furthermore, no stratification has been done to describe in more detail the highest risk group. Thus, there is an urgent need to establish a biomarker panel that can reliably detect PDAC at its earliest stages. If this need is not met, PDAC mortality will not decrease because curative treatments for late-stage PDAC remain elusive.

Although recent research by CNIO and KI suggests that stool analysis might be a valuable for early detection of PDAC (Kartal et al., 2022), the experience in colorectal cancer screening shows that stool testing is not well-accepted by the individuals at risk, which has propelled the search for a blood-based test. Blood can be easily taken by any medical worker (minimally invasive) and small volumes can be even self-sampled, making it prone to point-of-care devices. In PANCAID, we will therefore focus on the establishment of a blood test for early detection of PDAC which centrally addresses the core of the EU call text. Due to the rarity of early stage PDAC cases and respective biobank samples, this work cannot be done by a single institution but only in the context of an EU-wide consortium, starting with a collection of well-characterised biosamples.