The Urgent Need for Early Detection in Pancreatic Cancer

Pancreatic cancer remains one of Australia's most lethal diseases, with survival rates lagging far behind other common cancers. In 2025, an estimated 4,825 new cases were diagnosed, and the disease claimed over 4,000 lives, making it the third leading cause of cancer death. The pancreas, a gland located behind the stomach responsible for producing digestive enzymes and hormones like insulin (which regulates blood sugar), is notoriously difficult to monitor due to its deep position in the abdomen. Symptoms such as abdominal pain, unexplained weight loss, jaundice (yellowing of the skin), or new-onset diabetes often appear only when the cancer has advanced to stages III or IV, where five-year survival drops to less than 5%. In contrast, early-stage detection (stages I or II) can boost long-term survival rates up to 10 times higher, sometimes exceeding 30% with surgery and adjuvant therapies.

Australian health experts emphasize that while pancreatic ductal adenocarcinoma (PDAC, the most common form accounting for 95% of cases) has seen little improvement in outcomes over decades, with overall five-year survival at just 14%, breakthroughs in non-invasive screening could transform this landscape. Universities like the University of Queensland (UQ) are at the forefront, driving research into blood-based biomarkers that promise faster, more accessible detection.

UQ Researchers Spearheading Biomarker Innovation

At UQ's Frazer Institute, Associate Professor Jason Lee is leading a 2024-2025 project focused on developing an early detection biomarker specifically for pancreatic cancer. This initiative builds on UQ's strong track record in oncology research, leveraging genetic and proteomic analyses to identify circulating tumor DNA (ctDNA) and protein signatures in blood samples. Similarly, Dr. Michaela Kindlova received a 2025 Early Detection Grant from Pankind Pancreatic Cancer Australia to explore faulty DNA methylation patterns in pre-cancerous pancreatic tissue, aiming to pinpoint blood-detectable changes before tumors form.

These efforts align with broader Queensland research ecosystems. The Queensland Institute of Medical Research Berghofer (QIMR Berghofer), closely affiliated with UQ through joint appointments and collaborations, launched the PaCNOD Pilot Study in February 2026. Led by Professor Rachel Neale from QIMR's Cancer Aetiology and Prevention Laboratory, this trial screens individuals over 55 newly diagnosed with type 1 or type 2 diabetes using non-invasive CT scans. New-onset diabetes affects about 1 in 175 adults over 50 and can signal pancreatic tumors disrupting insulin production, providing a high-risk group for targeted screening. The study, supported by Pankind, recruits nationwide but starts in Brisbane, refining protocols for a potential national rollout.

From Lab to Clinic: How Blood Tests Detect Pancreatic Cancer Early

Blood tests for early pancreatic cancer detection target ctDNA—small fragments of tumor DNA shed into the bloodstream—or specific proteins elevated by cancer cells. Traditional biomarkers like CA19-9 (carbohydrate antigen 19-9, a sugar molecule on cell surfaces) have limitations: elevated in non-cancerous conditions like pancreatitis or biliary obstruction, and undetectable in 5-10% of patients due to genetic variants (Lewis-negative blood type). UQ-linked studies address this by combining multiple markers, such as genetically predicted blood proteins linked to PDAC risk.

The Avantect test, developed by Australian company BCAL Diagnostics and now available privately in Australia since January 2026 at $1,495, exemplifies this approach. It uses technology akin to pregnancy tests, detecting abnormal DNA methylation patterns indicative of pancreatic cancer with promising sensitivity in early stages. Administered to its first Australian patient in Brisbane, it's positioned as a surveillance tool for high-risk individuals (family history, genetic mutations like BRCA2). While not yet guideline-replacing (MRI and endoscopic ultrasound remain gold standards), ongoing trials like PRECEDE and Vanguard will validate its real-world utility.

Step-by-step, these tests work as follows:

• Sample Collection: A simple venous blood draw, no fasting required.
• Biomarker Analysis: Lab processes plasma for ctDNA or proteins using PCR amplification or mass spectrometry.
• AI Integration: Algorithms score multi-marker panels, flagging high-risk profiles.
• Results: Available in days, prompting imaging confirmation.

Pancreatic Cancer Statistics and Risk Factors Down Under

Australia's pancreatic cancer burden is rising, with incidence almost doubling over 20 years per Australian Bureau of Statistics data. Risk factors include smoking (20-30% attributable), obesity, chronic pancreatitis, family history (5-10% hereditary), and diabetes (2-3x risk). Indigenous Australians face higher incidence, underscoring health equity needs. New-onset diabetes in older adults warrants vigilance, as tumors can mimic or cause it by destroying insulin-producing beta cells.

Data from Cancer Australia and AIHW highlights the imperative for university-driven screening innovations.Cancer Australia Roadmap

Queensland's Research Ecosystem: UQ, QIMR, and Beyond

UQ's Diamantina Institute exemplifies translational research, where basic science meets clinical application. Projects like genetically predicted blood protein biomarkers for PDAC risk use Mendelian randomization to causally link plasma proteins to cancer onset, informing future tests. Collaborations with QIMR Berghofer amplify this: Prof Neale's team integrates epidemiology with imaging, while UQ geneticists probe methylation anomalies.

Historical context includes Queensland University of Technology's (QUT) 2018 Tri-platform test—a 10-minute hemin-enhanced electrochemical sensor detecting ctDNA for pancreatic and other cancers—pioneering rapid point-of-care diagnostics. Though proof-of-concept, it inspired UQ's focus on scalable biomarkers.

Challenges and Ethical Considerations in Screening

Developing reliable blood tests faces hurdles: low ctDNA abundance in early disease (0.01-1%), false positives from benign conditions, and cost-effectiveness for population screening. UQ researchers emphasize prospective validation in diverse cohorts, including Australia's multicultural population. Ethical issues include psychological burden of false alarms and equitable access, particularly in rural areas where 30% of cases occur.

• False Positives: Multi-marker panels reduce to 5%, vs. 20% for CA19-9 alone.
• High-Risk Focus: BRCA1/2 carriers, Lynch syndrome patients prioritized.
• Integration: With GP-led diabetes checks for scalable rollout.

Patient Stories and Real-World Impact

Paul Williams, the first PaCNOD participant, exemplifies hope. With family history and recent pancreatitis, his CT scan revealed a pancreatic mass treatable due to early detection. Stories like his underscore university research's human stakes, potentially saving thousands annually.

Future Directions: Clinical Trials and Routine Screening

Horizon includes UQ's biomarker validation trials and Avantect's integration into guidelines post-PRECEDE results. National Pancreatic Cancer Roadmap advocates blood tests for high-risk surveillance by 2030. AI-enhanced panels promise sub-hour results, akin to rapid antigen tests.

A QIMR Berghofer pilot details highlight momentum, with UQ poised to lead commercialization.

Career Opportunities in Cancer Research at Australian Universities

UQ and partners seek postdocs, research assistants, and lecturers in oncology. Brisbane's ecosystem offers roles in biomarker discovery, clinical trials, and bioinformatics. With NHMRC funding surging, explore research jobs advancing early detection.

Stakeholder Perspectives: From Researchers to Advocacy Groups

Prof Neale: "Pancreatic cancer has one of the worst survival rates; screening high-risk diabetics could change that." Michelle Stewart (Pankind): "Tools like Avantect complement surveillance, buying time for cures." UQ's Jason Lee stresses multi-omics integration for precision medicine.

Global Context and Australia's Leadership

While US NIH panels advance, Australia's agile trials position UQ as a leader. Lessons from breast/prostate screening inform pancreatic strategies, promising 50% survival uplift by 2035.

Photo by Malcolm Choong 鍾声耀 on Unsplash