Pancreatic Cancer: State of the Art and Current Situation in the Islamic Republic of Iran

Compared to western countries, pancreatic cancer has a relatively low incidence in iran. it is rarelydiagnosed before the fifth decade in iran and most of the patients are older than 60 at the time ofdiagnosis like to the western countries, where pancreatic cancer is a disease of advanced age. theincidence of the disease in some young patients suggests a possible role of genetic defects, whichis probably due to high consanguineous marriages in iran. despite many efforts in improvingdiagnosis and treatment of pancreatic cancer, this disease has still dismal prognosis. the analysisof the spatial spread of the pancreatic cancer in mazandaran and golestan, two provinces in thecaspian sea region in the north of iran, which comprise a low incidence of pancreatic cancer,showed that the disease , unlike other gastrointestinal tract cancers, does not exhibit high incidenceclusters in the region. our knowledge about the molecular and cellular pathology of the pancreaticcancer has progressed, and many agents including anti-egfr, anti-vegf, and immunotherapeuticagents have been applied for the treatment of the disease. however, surgery remains the onlycurative approach and further research is paramount to identify novel diagnostic and predictivebiomarkers for early diagnosis and treatment stratification. pancreatic cancer requires aninterdisciplinary approach which involves surgery, pathology, radiology, gastroenterology,oncology, and palliative care provided in dedicated, specialized centers