The American Cancer Society (ACS) estimates that about 67,530 people (35,190 men and 32,340 women) will be diagnosed with pancreatic cancer, and about 52,740 people (27,230 men and 25,510 women) will die of pancreatic cancer in 2026. Out of all cancers, pancreatic cancer has the highest mortality rate, with the five-year survival rate being 13% for all stages combined.
Black Americans have the highest incidence of pancreatic cancer in the United States compared to any other racial or ethnic group. This disparity often results from late-stage diagnoses and worse survival rates, driven by risk factors like diabetes, smoking, obesity, and systemic barriers. Earlier detection and treatment could prevent disease progression and lead to better outcomes for Black patients with pancreatic cancer.
In a recent study from the National Institutes of Health (NIH), researchers identified new blood markers that may detect early pancreatic cancer. This new test could improve overall survival rates, particularly for Black patients.
What the Study Says
The study, published in Clinical Cancer Research, involved scientists from the University of Pennsylvania Perelman School of Medicine and the Mayo Clinic, who used a phased approach to test blood biomarkers in patients with pancreatic cancer and in patients with similar malignancies. They used two previously explored biomarkers to assess disease detection: carbohydrate antigen 19-9 (CA19-9) and thrombospondin 2 (THBS2). Neither marker is an effective screening tool.
When analyzing blood samples, the researchers identified two novel biomarkers that were elevated in patients with early-stage pancreatic cancer compared with healthy volunteers: aminopeptidase N (ANPEP) and polymeric immunoglobulin receptor (PIGR).
When the two biomarkers were combined with CA19-9 and THBS2, the four-marker panel successfully distinguished pancreatic cancer cases from non-cases 91.9% of the time across all stages, at a false-positive rate of 5% in non-cases. For early-stage cancer, the four-marker test idenfitied 87.5% of cases.
“By adding ANPEP and PIGR to the existing markers, we’ve significantly improved our ability to detect this cancer when it’s most treatable,” the study’s lead investigator, Kenneth Zaret, Ph.D., told NIH.
More importantly, the four-market test successfully distinguished patients with cancer from both healthy individuals and those with non-cancerous pancreatic conditions, such as pancreatitis.
“Our retrospective study findings warrant further testing in larger populations, particularly in people before they show symptoms,” Zaret said. “Such ‘prediagnostic’ studies would help determine if the test could be used as a screening tool for people at high risk of developing the disease based on family history, genetic screening results, or personal history of pancreatic cysts or pancreatitis.”
Why Earlier Detection Matters More for Black Patients
Pancreatic cancer has an exceptionally high mortality rate because symptoms rarely appear in the early stages. Most patients are diagnosed only after the cancer has spread beyond the pancreas, when surgery—the only potentially curative treatment—is no longer possible. By that point, treatment is focused on prolonging life rather than curing the disease.
For Black patients with pancreatic cancer, the issue is even more severe.
Studies consistently show that Black Americans are more likely to:
- Be diagnosed at a later stage
- Have tumors that are not surgically removable
- Experience delays in specialty referrals
- Receive less aggressive treatment
- Have lower survival rates
Since pancreatic cancer progresses quickly, even a delay of a few months can significantly change survival outcomes. This signals that a reliable blood test capable of detecting the disease earlier could narrow one of the most dangerous gaps in cancer care.
In communities where access to specialty imaging, gastroenterology care, and genetic testing may be limited, a simple blood test could function as a gateway to potentially lifesaving treatment.
Understanding the New Biomarker Panel
Currently, clinicians sometimes use the biomarker CA19-9 to monitor pancreatic cancer after diagnosis, but it has significant limitations:
- It is not reliable in detecting early-stage disease
- Some patients don’t produce CA19-9 at all
- Levels can rise in non-cancerous conditions like gallstones or pancreatitis
These factors make CA19-9 an unsuitable screening tool—particularly for populations already at a higher risk.
The newly identified biomarkers, ANPEP and PIGR, appear to detect biological changes that occur much earlier in tumor development. When combined with CA19-9 and THBS2, the panel significantly improves detection accuracy.
What makes this so crucial is not just accuracy, but timing.
Rather than identifying cancer after symptoms like weight loss, jaundice, or severe abdominal pain appear, this test could identify the disease during the silent phase, when tumors are still small and surgically removable.
For Black pancreatic cancer patients, who are likelier to encounter barriers before specialist evaluation, early detection before symptoms appear could dramatically change survival patterns nationwide.
Risk Factors Affecting Black Patients with Pancreatic Cancer
The higher incidence of pancreatic cancer in the Black community is not caused by an isolated factor. It arises from a combination of environmental exposure, biological risk, and structural inequality.
- Diabetes and prediabetes: Black adults are 60% more likely than white adults to be diagnosed with diabetes. Long-standing diabetes and new-onset diabetes after age 50 are both strongly associated with the risk of pancreatic cancer.
- Smoking: Tobacco use remains one of the most preventable pancreatic cancer risk factors. Despite smoking rates declining, menthol cigarettes targeting Black communities have historically increased tobacco exposure. Smoking nearly doubles pancreatic cancer risk.
- Obesity and chronic inflammation: Higher rates of obesity and metabolic syndrome—shaped by food access, neighborhood design, and socioeconomic factors—increase chronic inflammation. Chronic inflammation can contribute to the formation of pancreatic tumors.
- Chronic pancreatitis: Inflammation of the pancreas, often undiagnosed or undertreated, significantly increases lifetime risk of pancreatic cancer.
- Environmental and structural factors: Access to preventive care, health insurance coverage, trust in medical care, and referral patterns all influence whether patients receive timely imaging or genetic testing.
Moving Toward Equity in Pancreatic Cancer Care
Pancreatic cancer has long been one of the deadliest cancers because it hides. For Black Americans, the danger has been compounded by delayed diagnosis and fewer opportunities for early treatment.
The discovery of new blood biomarkers does not immediately solve health disparities, but it represents a shift in strategy. Rather than relying solely on symptoms, specialists, and advanced imaging, detection may be moved upstream into routine medical care.
For the Black community, which constantly faces systemic barriers to specialty medicine, such a change could be transformative.
If future research confirms these findings, a simple blood test could become one of the most critical tools yet in improving pancreatic cancer outcomes for Black patients.