1.Smoking: Studies have confirmed that the risk of smokers is proportional to their smoking level. Diet structure: High protein diet such as meat and high calorie diet such as high carbohydrate are factors related to the development of pancreatic cancer. Animal experiments have proved that high fat diet is related to the development of pancreatic cancer. People with high fiber, fruits and fresh vegetables in their diet structure have less pancreatic cancer. 3. Environmental factors: Occupations associated with pancreatic cancer are jobs with chemical substances and metal contact. Such as beta-naphthylamine and benzene. Genetic factors: The risk of pancreatic cancer is higher for those who have malignant pancreatic tumors in their close relatives. Diabetes: The risk of pancreatic cancer is four times higher in diabetic patients than in others, but there are many studies that do not support the correlation between diabetes and pancreatic cancer. Clinicians have found that there are often episodes of diabetes in the months before pancreatic cancer is confirmed, reminding middle-aged patients without a family history of diabetes to consider the possibility of early pancreatic cancer. 6. Chronic pancreatitis: It is also one of the precancerous lesions of pancreatic cancer, especially chronic calcific pancreatitis. It is important to note that pancreatitis attack may be the first symptom of pancreatic cancer. The incidence of pancreatic cancer is significantly increasing worldwide, and the incidence in China has also increased significantly in the last decade. In the United States, there were 29,200 new cases of pancreatic cancer in 2001, and about 28,900 people died from pancreatic cancer, and its incidence has exceeded that of stomach cancer. In Shanghai, the incidence and mortality rate of pancreatic cancer rose from the 10th to the 8th and 6th place in the tumor rankings respectively during the 20 years from 1980 to 2000, and the incidence and mortality rate increased by about 50%. Pancreatic cancer is not easily diagnosed at an early stage, and when it is found, it is mostly in the middle and late stages, and the previous surgical resection rate is only 10%-20%, while its malignant degree is high, and the metastasis rate of liver and lymph nodes is high, and it is not sensitive to radiotherapy and chemotherapy. Therefore, it is called “the king of cancer” and “the cancer of the 21st century”. Shao Chenghao, Department of General Surgery, Shanghai Long March Hospital There are no characteristic symptoms in the early stage of pancreatic cancer. The first symptoms, such as pain in the upper abdomen, fullness and distension, loss of appetite, etc., are easily confused with common diseases of the digestive tract, such as gastrointestinal, hepatobiliary diseases, which do not easily attract the attention of patients and clinicians, and the neglect of relevant examinations for pancreatic tumors is an important reason for delaying the diagnosis. It is often difficult to obtain long-term survival when jaundice, severe low back pain, wasting, weakness and other mid- to late-stage clinical manifestations appear. Therefore, to improve the early diagnosis rate of pancreatic cancer, it is necessary to first enhance the vigilance of pancreatic cancer. The following conditions are considered as high-risk groups of pancreatic cancer and should be alerted to the possibility of pancreatic cancer: 1. Those who have symptoms such as upper abdominal pain, bloating and abdominal discomfort over 40 years old, and gastroscopy and ultrasound do not reveal any common upper gastrointestinal diseases such as gastric disease and cholecystitis, should be alerted to the possibility of pancreatic disease; 2. Those who have family history of pancreatic cancer: pancreatic cancer has a genetic tendency, and if parents have a history of pancreatic cancer, they should also 3.Patients with sudden onset of diabetes, especially those without a family history of diabetes and diabetes-prone factors such as obesity, who develop insulin resistance soon after the onset (high blood glucose, which is not easily controlled by insulin); 4.Recurring episodes of chronic pancreatitis, especially chronic familial pancreatitis and chronic calcific pancreatitis. 5, unexplained episodes of acute pancreatitis. It manifests as sudden onset of epigastric pain, and the diagnosis of acute pancreatitis is made when the blood and urine amylase is found to be elevated at the hospital visit. If there is no common cause of acute pancreatitis such as biliary tract disease, alcohol consumption, hyperlipidemia, etc., a comprehensive examination should be done for pancreatic cancer. In our clinic, we found that about 15% of patients with pancreatic cancer have acute pancreatitis as their first symptom. Large hospitals with pancreatic surgery centers are the first choice for the treatment of pancreatic cancer patients. A large number of clinical studies at home and abroad have shown that experienced pancreatic surgeons have a significantly higher rate of correct diagnosis and successful surgical treatment of pancreatic cancer than non-specialist surgeons. The Department of General Surgery of Changhai Hospital (Pancreatic, Spleen, Hepatobiliary) was established in 1989 as a specialized group of pancreatic surgery. In the past 20 years, it now performs more than 500 cases of various pancreatic surgeries annually, and has accumulated rich experience in the external treatment of pancreatic cancer, and is capable of providing specialized and standardized diagnosis and treatment for patients with suspected pancreatic cancer. Ultrasound is easy, economical, non-invasive and repeatable, and is the preferred means of screening patients with suspected pancreatic cancer in clinical practice. Thin-section, dynamic, enhanced CT scans have a positive rate of about 90% and are the most commonly used method to diagnose pancreatic cancer. Magnetic resonance cholangiopancreatography (MRCP), retrograde cholangiopancreatography (ERCP) examination, and endoscopic ultrasound (EUS) can also provide important diagnostic clues. Positron emission tomography (PET) can detect lymph nodes and small liver metastases that cannot be detected by CT and EUS, and differentiate from chronic pancreatitis. CA19-9 is an oncological index related to pancreatic cancer, and about 75% of pancreatic cancer patients have elevated blood CA19-9. the normal value of CA19-9 is less than 37 U/L. All patients with suspected pancreatic cancer should have their blood CA19-9 checked. it is worth noting that: 1. the absence of elevated CA19-9 does not mean the absence of pancreatic cancer, because about 25% of pancreatic cancer patients do not have high CA19-9; 2. The diagnostic value of CA19-9 should be considered together with the imaging results.