Pancreatic Cancer

Pancreatic cancer is often diagnosed late because early disease rarely causes clear symptoms and there is no effective screening test for people at average risk. Major guidelines—including the U.S. Preventive Services Task Force—recommend against screening asymptomatic adults using blood tests, ultrasound, CT/MRI, endoscopic ultrasound (EUS), or any other method. 

Testing becomes important in two situations:

  1. Evaluating symptoms or abnormal imaging/labs, and

  2. Surveillance of people at high hereditary risk, typically in expert centers using MRI/MRCP and/or EUSaccording to consensus protocols (not blood tests). 

Ulta Lab Tests offers supportive laboratory tests—for example CA 19-9 (tumor marker used in management, notscreening), CEAliver panel (bilirubin, AST/ALT, ALP)metabolic panelsA1c/glucose, and lipase—that your clinician may order alongside imaging to help triage, stage, or monitor disease. 


Signs & Situations (When to consider testing)

Screening without symptoms is not recommended for average-risk people. See your clinician promptly if you have:

  • Persistent upper abdominal or back painjaundice (yellow skin/eyes), dark urine/pale stools, or itching.

  • Unintentional weight lossloss of appetitenausea, or new steatorrhea (greasy stools).

  • New-onset diabetes or rapidly worsening glucose control, especially after age 50 (area of active research; not a stand-alone screening test). 

  • An incidentally discovered pancreatic cyst or mass on imaging (evaluation is clinician-directed).

  • Strong family history or a known pathogenic variant (e.g., BRCA1/2, PALB2, CDKN2A, STK11/Peutz-Jeghers, Lynch). Ask about referral to a high-risk surveillance program

SEO synonyms: pancreatic cancer blood tests, CA 19-9 test, pancreatic tumor markers, EUS, MRCP, hereditary pancreatic cancer screening.


Why These Tests Matter

What pancreatic-cancer-related testing can do

  • Support diagnosis, staging, and monitoring of known or suspected cancer: CA 19-9 (with caveats), CEA, and chemistry panels help assess tumor burden and biliary obstruction; trends may inform treatment response under oncology care. 

  • Identify high-risk individuals for specialty surveillance (MRI/MRCP, EUS) based on family history or pathogenic variants—performed in expert centers. 

What testing cannot do

  • Screen the average-risk population effectively or reduce deaths; CA 19-9 and imaging are not screening toolsfor asymptomatic people. 

  • Diagnose cancer by blood test alone—abnormal markers require imaging and, when feasible, tissue diagnosis.


What These Tests Measure (at a glance)

  • CA 19-9: A tumor-associated carbohydrate antigen often elevated in pancreatic cancer, but also in benign cholestasis, pancreatitis, cholangitis, and in people who do not produce the Lewis antigen it may be undetectable. Most useful for baseline and trend monitoring in diagnosed disease; not for screening

  • CEA: Sometimes followed in GI cancers; adjunct to CA 19-9 in management, not screening.

  • Liver panel (bilirubin, ALP, AST/ALT) & CMP: Evaluate biliary obstruction and overall organ function.

  • Glucose/A1c: New-onset or worsening diabetes can coexist with pancreatic cancer and may prompt evaluation in context.

  • Lipase/Amylase: Assess pancreatitis (not cancer-specific).

  • Genetic testing (germline): Offered after risk assessment/counseling when family history suggests an inherited syndrome (managed with specialized teams). 


How the Testing Process Works

  1. Risk & symptom review: Your clinician takes a history and exam; if concerning, they may order CT/MRI or EUS first.

  2. Order supportive labs: CA 19-9, CEA, liver panel, CMP, A1c/glucose, lipase to complement imaging findings. 

  3. High-risk surveillance: If you qualify (hereditary/familial risk), surveillance typically uses MRI/MRCP and/or EUS at set intervals in an experienced center—not blood-test-based screening. 

  4. Results & next steps: Abnormal markers or imaging lead to specialist referral for definitive work-up and management.


Interpreting Results (general guidance)

  • Elevated CA 19-9 supports, but does not confirm, pancreatic cancer; obstructive jaundice and inflammation can falsely raise it. Trends during therapy are more informative than a single value. 

  • Normal CA 19-9 doesn’t exclude cancer—some tumors don’t secrete it, and Lewis-antigen-negative individuals do not produce CA 19-9 at all.

  • CEA is nonspecific; interpret only in oncology context.

  • Normal labs do not rule out disease; decisions are based on the total picture (symptoms, imaging, pathology).

Always interpret results with a qualified healthcare professional.


Choosing Panels vs. Individual Tests

  • Average risk, no symptoms: Do not screen with CA 19-9 or imaging. Follow routine preventive care and seek evaluation if symptoms arise.

  • Suspicious symptoms or imaging: order CA 19-9 ± CEAliver panel/CMPglucose/A1clipase—to complement imaging and clinical assessment.

  • High-risk individuals (hereditary/familial): referral to a high-risk pancreas clinic for MRI/MRCP/EUS-based surveillance per AGA/CAPS recommendations.

  • Monitoring known cancer (oncologist-directed): serial CA 19-9 (if elevated at baseline) plus imaging per guideline.


FAQs

Who should consider surveillance?
People with pathogenic variants (e.g., BRCA1/2, PALB2, CDKN2A, STK11) or strong familial clustering, managed in expert centers using MRI/EUS, not blood-test screening.

Does new-onset diabetes mean I have pancreatic cancer?
Usually no, but in some older adults it can be a warning sign. Researchers are studying how to identify the small subset at highest risk.

Can CA 19-9 be high for noncancer reasons?
Yes—bile duct blockage, cholangitis, pancreatitis, liver disease, and other conditions can raise it. Interpretation requires clinical context.


Internal Links & Cross-References

  • Cancer Screening Hub

  • Liver & Biliary Tests

  • Colorectal Cancer

  • Multi-Cancer Early Detection (MCED)

  • Men’s Cancer & Tumor Markers

  • Women’s Cancer & Tumor Markers

  • Key Lab Tests: CA 19-9 • CEA • Comprehensive Metabolic Panel • Liver Panel (Bilirubin/ALP/AST/ALT) • A1c/Glucose • Lipase


References

  1. U.S. Preventive Services Task Force. Pancreatic Cancer: Screening. Final Recommendation Statement. JAMA, August 6, 2019.

  2. Aslanian HR, et al. AGA Clinical Practice Update on Pancreas Cancer Screening in High-Risk Individuals. Gastroenterology. 2020.

  3. Goggins M, et al. CAPS Consortium Recommendations: Management of Patients with Increased Risk for Familial Pancreatic Cancer. Gut. 2020 (and correction 2019).

  4. NCCN Guidelines for Patients: Pancreatic Cancer. Version 2025.

  5. Wu E, et al. CA 19-9 and Pancreatic Cancer: A Comprehensive Review. International Journal of Molecular Sciences. 2013.

  6. NCI Cancer Currents Blog. New-Onset Diabetes as a Potential Early Sign of Pancreatic Cancer. July 7, 2021.

  7. ASCO Guideline Update: Metastatic Pancreatic Cancer—Use of CA 19-9 in Management and Monitoring. Journal of Clinical Oncology. 2020.


Available Tests & Panels

Tip: Use CA 19-9 ± CEA and liver/metabolic panels to support clinician-directed evaluation and follow-up; reserve surveillance for high-risk patients in specialized programs—there is no routine screening for average-risk adults.

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The CA 19-9 Test measures levels of carbohydrate antigen 19-9 in blood, a tumor marker often elevated in pancreatic cancer and sometimes in bile duct, colorectal, or liver cancers. While not used alone for diagnosis, it helps monitor treatment, track disease progression, and detect recurrence. Elevated CA 19-9 may also occur in noncancerous conditions. Doctors use this test to support cancer management and guide therapy decisions.

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Also Known As: CA 19-9 Tumor Marker, Cancer Antigen 19-9 Test

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The CEA Test measures carcinoembryonic antigen levels in blood, a protein that may be elevated in certain cancers, especially colorectal, pancreatic, lung, breast, or ovarian cancer. It is not used alone for diagnosis but helps monitor cancer treatment, detect recurrence, and track disease progression. Elevated CEA can also occur in noncancerous conditions. Doctors use this test to support therapy decisions and provide insight into cancer management.

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Also Known As: Carcinoembryonic Antigen Test

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The Amylase Test measures amylase enzyme levels in blood to evaluate pancreatic and digestive health. Elevated amylase may indicate pancreatitis, gallbladder disease, intestinal blockage, or salivary gland disorders, while low levels may suggest chronic pancreatitis or liver damage. Doctors order this test to investigate abdominal pain, nausea, or fever. Results provide vital insight into pancreatic function, digestive disorders, and overall metabolic health.

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Also Known As: Amy Test

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The Lipase Test measures levels of lipase, an enzyme made by the pancreas that helps digest fats. Elevated lipase may indicate acute or chronic pancreatitis, pancreatic cancer, gallbladder disease, kidney failure, or bowel obstruction. Doctors order this test to investigate severe abdominal pain, nausea, or vomiting and to monitor pancreatic disorders. Results provide vital insight into digestive health, pancreatic function, and overall gastrointestinal balance.

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Also Known As: LPS Test

The Comprehensive Metabolic Panel (CMP) Test measures 21 markers to assess metabolic health, liver and kidney function, and electrolyte balance. It includes glucose, calcium, sodium, potassium, chloride, CO2, albumin, globulin, A/G ratio, total protein, bilirubin, ALP, AST, ALT, BUN, creatinine, BUN/creatinine ratio, and eGFR. The CMP helps detect diabetes, liver or kidney disease, and supports routine screening and chronic condition monitoring.

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Also Known As: CMP Test, Chemistry Panel Test, Chem Test, Chem 21 Test, Chem 14 Test 

The Complete Blood Count with Differential and Platelets Test is a comprehensive blood test that checks red blood cells, white blood cells, hemoglobin, hematocrit, and platelets. The differential analyzes types of white blood cells to detect infections, anemia, clotting abnormalities, immune conditions, and certain cancers. This essential test is often ordered for routine health exams, diagnosis, and monitoring treatment progress.

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Also Known As: CBC Test, CBC with Differential and Platelets Test, CBC w/Diff and Platelets Test, Full Blood Count Test, Complete Blood Count Test

The Albumin Test measures albumin, the main protein made by the liver that maintains fluid balance and transports hormones, vitamins, and medications. Low albumin may indicate liver disease, kidney problems, malnutrition, or chronic inflammation, while high levels may reflect dehydration. Doctors order this test to evaluate swelling, fatigue, or abnormal labs. Results provide key insight into nutritional status, liver and kidney function, and overall metabolic health.

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Also Known As: ALB Test

The ALP Test measures alkaline phosphatase enzyme levels in blood to evaluate liver, bone, and bile duct health. High ALP may indicate liver disease, bile duct obstruction, bone disorders, or certain cancers, while low levels may suggest malnutrition or deficiency. Doctors order this test to investigate symptoms like fatigue, abdominal pain, or bone pain and often pair it with other liver function tests. Results provide key insight into metabolic and organ health.

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Also Known As: Alkaline Phosphatase Test, Alk Phos Test, Alkp Test

The Alpha-1 Antitrypsin 24 Hour Feces Test measures levels of alpha-1 antitrypsin in stool to evaluate protein loss through the gastrointestinal tract. Elevated results indicate protein-losing enteropathy, a condition where proteins leak into the intestines. This test provides valuable insight into unexplained edema, malnutrition, or chronic diarrhea, helping clinicians assess digestive health and guide evaluation of protein metabolism.

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Also Known As: Alpha-1 Antitrypsin Test, A1AT Test, AAT Test, Alpha-1 Antitrypsin Feces Test

The ALT Test measures alanine aminotransferase, an enzyme mainly found in the liver. Elevated ALT may indicate liver damage from hepatitis, fatty liver disease, cirrhosis, alcohol use, or medication effects. Doctors order this test to evaluate symptoms such as fatigue, abdominal pain, or jaundice and often pair it with AST for accurate liver assessment. Results provide essential insight into liver health, enzyme activity, and overall metabolic function.

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Also Known As: Alanine Aminotransferase Test, GPT Test, SGPT Test, Serum Glutamic Pyruvic Transaminase Test

The AST Test measures aspartate aminotransferase, an enzyme found in the liver, heart, muscles, and other tissues. Elevated AST may indicate liver disease, heart attack, muscle injury, or other organ damage. Doctors order this test to evaluate symptoms such as fatigue, weakness, or jaundice and often pair it with ALT for accurate liver assessment. Results provide key insight into liver function, muscle health, and overall metabolic balance.

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Also Known As: Aspartate Aminotransferase Test, Serum Glutamic-Oxaloacetic Transaminase Test, SGOT Test

The Bilirubin Direct Test measures conjugated bilirubin in the blood to assess liver function and bile duct health. Elevated levels may indicate hepatitis, cirrhosis, gallstones, or bile duct obstruction, while low levels are generally normal. Doctors order this test for patients with jaundice, fatigue, or suspected liver disease. Results help diagnose and monitor liver disorders, guide treatment decisions, and evaluate overall hepatic and biliary health.

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Also Known As: Direct Bilirubin Test

The Fractionated Bilirubin Test separates total bilirubin into direct and indirect forms to assess liver and blood health. Elevated direct bilirubin may point to hepatitis, cirrhosis, or bile duct obstruction, while elevated indirect levels can signal hemolytic anemia or inherited disorders. Doctors order this test for jaundice, anemia, or suspected liver conditions. Results help guide diagnosis, treatment, and monitoring of liver and blood disorders.

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Also Known As: Fractionated Bilirubin Test

The Chromogranin A Test measures levels of chromogranin A, a protein often elevated in neuroendocrine tumors. It helps doctors monitor tumor presence, treatment response, and recurrence. Elevated results may also occur with conditions such as chronic atrophic gastritis, inflammatory diseases, or use of proton pump inhibitors. Combined with imaging and other tumor markers, this test supports the diagnosis and management of neuroendocrine disorders.

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The Galectin-3 Test measures levels of galectin-3, a biomarker linked to heart failure, cardiac fibrosis, and inflammation. Elevated results may indicate worsening heart disease, increased risk of hospitalization, or progression of chronic conditions. Doctors use this blood test to assess heart health, guide treatment decisions, and monitor patients with heart failure, offering valuable insight into long-term cardiovascular risk and management.

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The Glucagon Test evaluates hormone levels that regulate glucose by stimulating the liver to release stored sugar. Elevated or low glucagon may indicate diabetes, hypoglycemia, metabolic disorders, or pancreatic disease. This test provides insight into endocrine activity, glucose balance, and systemic health conditions related to energy metabolism and hormonal function.

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The Hepatic Function Panel Test measures liver enzymes, proteins, and bilirubin to assess liver health and function. It includes ALT, AST, ALP, albumin, total protein, and bilirubin levels. Abnormal results may indicate hepatitis, cirrhosis, fatty liver, or bile duct problems. Doctors use this test to investigate jaundice, nausea, abdominal pain, or fatigue and to monitor liver disease, alcohol use, or medication side effects affecting liver function.

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Also Known As: Liver Function Panel Test, LFT

The Liver Function Panel, also known as a Hepatic Function Panel, measures proteins, enzymes, and bilirubin to assess liver health and function. It helps detect liver disease, monitor liver conditions, and evaluate the effects of medications or other factors on liver performance.

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Also Known As: Hepatic Function Panel Test, HFP Test

The Pancreatic Polypeptide Test measures pancreatic polypeptide levels in blood to evaluate pancreatic endocrine function. Elevated results may occur with pancreatic tumors, endocrine disorders, or autonomic nervous system dysfunction. This test helps assess abnormal hormone secretion, monitor suspected neuroendocrine tumors, and provide clinical insight into metabolic and gastrointestinal regulation.

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The Protein Total Serum Test evaluates total protein concentration, reflecting both albumin and globulin, which play key roles in immune response, liver function, and nutrient transport. Abnormal findings may signal malnutrition, kidney or liver disease, or chronic inflammatory conditions. This test aids in assessing protein metabolism, systemic health, and overall physiological balance.

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The Reducing Substances Stool Test measures sugars in stool to assess carbohydrate digestion and absorption. Elevated levels can point to lactose intolerance, hereditary enzyme deficiencies, or gastrointestinal conditions affecting nutrient breakdown. By identifying unabsorbed carbohydrates, this test helps clinicians evaluate chronic diarrhea, bloating, abdominal discomfort, or pediatric feeding problems, offering valuable information about intestinal and metabolic health.

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Blood, Stool
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Pancreatic Cancer refers to the development of abnormal cells within the pancreas. As the cancerous or abnormal cells continue to develop, they turn into malignant tumors and damage the pancreas leading to a long list of symptoms. These tumors also cause the pancreas to cease working as it should in a healthy human being before the cancer spreads to other organs and/or tissues.   

Generally described as a flat, narrow-sized gland, the pancreas is about 6 inches in length and resides within the abdominal cavity, situated under the liver and behind the stomach. The pancreas is noted for having three distinct sections (head, body, and tail). For the head section, it is connected into the duodenum or small intestine. 

There are small-sized ducts inside the pancreas designed to push bicarbonate and digestive enzymes into the pancreatic duct. The pancreatic duct itself stretches across the pancreas (head to tail) and straight into the small intestine.  

It’s also important to note that there is a common bile duct that is positioned through the head of the pancreas and is responsible for transporting bile from the gallbladder/liver into the small intestine. The two ducts (bile and pancreatic) end up joining at the entrance of the small intestine (duodenum) as they have access to the same opening. 

The pancreas is made of two types of tissues:

The exocrine pancreas is responsible for producing active enzymes to handle proteins, fats, and carbs within the small intestine. When the enzymes are produced, they are carried forward into the small intestine before being activated as required.  

The endocrine pancreas is responsible for producing and releasing hormones such as glucagon and insulin before pushing them into the blood. By doing this, the body can regulate its blood glucose level at the cellular level and use it as a form of energy.   

With pancreatic cancers, abnormal cell development begins within the exocrine tissues.  Due to this, it becomes challenging to diagnose early-stage pancreatic cancer in patients as the symptoms are limited/absent without visible tumors that would demand an immediate physical examination. Once the symptoms do arise, the patient starts having severe symptoms such as jaundice because cancer has spread throughout the body. 

Cancer is also able to start within the pancreatic cells that are responsible for hormone production (i.e., neuroendocrine cells). When this happens, they produce what are known as neuroendocrine tumors (or islet cell tumors), but this is far rarer than conventional exocrine tumors. 

With islet cell tumors, most of them are known for being benign/non-cancerous, which means they don’t spread throughout the body. However, malignant/cancerous cells are known to grow at a slower pace in comparison to exocrine tumors. 

To diagnose or detect islet cell tumors, it’s possible to do so at an earlier stage as they do appear with a long list of symptoms due to the excessive pancreatic hormone production such as glucagon and insulin. Certain tests can be used to determine whether or not these hormone levels are spiked in the blood. 

The rest of this guide will focus on exocrine tumors (i.e., pancreatic ductal adenocarcinoma) as they are far more common than islet cell tumors. 

Pancreatic cancer is renowned for being the fourth-leading reason for cancer-related death in the US across men and women. Research by the American Cancer Society states that approximately 57,000 Americans are diagnosed with this type of cancer each year, and 46,000 die each year. This particular type of cancer causes more deaths in men than in women.  

Risk Factors 

A common reason for pancreatic cancer is smoking. Studies have shown 25% of pancreatic cancers are caused by smoking cigarettes, cigars, and/or smokeless tobacco products. If a person stops smoking, their risk for pancreatic cancer begins dropping substantially. 

Additional risk factors include: 

  • Chronic Pancreatitis 
  • Excessive Weight 
  • Family History of Pancreatic Cancer/Pancreatitis 
  • History of Diabetes (Especially Type 2 Diabetes) 
  • Genetic Predisposition (i.e., Hereditary Ovarian Cancer Syndrome, Breast Cancer, Familial Atypical Multiple Mole Melanoma Syndrome) 

Signs and Symptoms 

There is a common set of symptoms associated with pancreatic cancer, but most of them are subtle. 

These can include: 

  • Itchy Skin 
  • Nausea 
  • Loss of Appetite 
  • Light-Colored Stools 
  • Dark Urine 
  • Abdominal Pain/Back Pain 
  • Jaundice 
  • Extreme Fatigue 
  • Unexplained Weight Loss 

It’s important to note that these symptoms are also present with other conditions aside from pancreatic cancer. This causes the diagnosis to be missed during the earlier stages of pancreatic cancer. Most of these cases are recognized when a person is vomiting or has chronic pain, irregular blood sugar control, and/or malabsorption. This is when cancer starts to spread onto other organs and/or tissues. 

Lab Testing 

As of right now, there are no specific lab tests to run for early-stage pancreatic cancer. Researchers continue to pour time into finding the right test to detect pancreatic cancer during the early stages of this condition, as that is when it’s most treatable. There have been certain breakthroughs when it comes to experimental tests, but nothing concrete is available in the form of a screening/diagnostic test. 

If you have been diagnosed with pancreatic cancer, additional blood tests are run to help determine the prognosis and appropriate treatment plan.  

These can include: 

CEA (or Carcinoembryonic Antigen) – This is not reserved just for pancreatic cancer, but it can spot elevated levels of the tumor and help with the prognosis 

CA 19-9 (or Cancer Antigen 19-9) – This is a test to find a tumor marker to measure the pancreatic cancer treatment and its effectiveness. It doesn’t assist with the diagnosis process as many non-cancerous conditions also come with elevated CA 19-9 levels. 

There are additional lab tests that can be run at the same time: 

Comprehensive Metabolic Panel (or CMP) – These are multiple tests run to assess the condition of a patient’s kidneys and liver after a jaundice diagnosis. 

Complete Blood Count (or CBC) – This helps assess the blood cells (platelets, red blood cells, white blood cells). 

Amylase/Lipase – This test assists with assessing the blood for a person’s pancreatic enzymes, which can be elevated due to pancreatic cancer but are far more common in non-cancerous pancreatic disease.