Inclusion Criteria

• Cases
  • Pancreatic cancer (adenocarcinoma)
  • Pancreatic precancer (includes IPMN (Branch-IPMN, Main duct-IPMN, Mixed-IPMN), Mucinous cystic neoplasms, and Serous cystadenomas)
  • If surgery is not done, a chart review may be done for up to 5 years to follow the cyst over time.
• Controls
  • Normal pancreas on EUS (or absence of features suggesting neoplasia)
  • No personal history of pancreatic neoplasia or of GI cancer at any level
  • Includes
    • Asymptomatic patients undergoing surveillance or diagnostic examination
      • Ideal group would be those undergoing EUS for evaluation of non-pancreatic lesions unlikely to shed luminal cells (e.g. small submucosal gastric lesions)
    • Patients with chronic dyspepsia (> 2 years), iron deficiency, or anemia
    • Patients with family history of pancreatic cancer
    • Patients with recurrent idiopathic pancreatitis or chronic pancreatitis found to have no lesions suspicious for pancreatic cancer on imaging

Exclusion Criteria

• A positive pregnancy test
  • A pregnancy test will be obtained in premenopausal women agreeing to participate,and must be shown to be negative prior to endoscopy and secretin injection
• Organ transplant
• Pancreatic cancer is a recurrence
• Received a chemotherapy class drug in past 6 months or are actively receiving one
• Therapeutic radiation to esophagus or thorax/chest