The incidence rate of pancreatic cancer in China is 5.1/100,000, which is significantly higher than 20 years ago. The incidence of pancreatic cancer in men in Shanghai is close to that in Europe and the United States. Only 10%-15% of patients have the chance of surgical resection, and only 5%-7.5% of them can be cured. The prognosis of pancreatic cancer is extremely poor, the National Institutes of Health reported that the 1-year survival rate of pancreatic cancer is 8%, the 5-year survival rate is 3%, and the median survival period is only 2-3 months. Our surgical statistics show that the 5-year survival rate is around 5%. Challenges faced First, the early diagnosis rate of pancreatic cancer is low. It is not clear which are the risk factors for the incidence of pancreatic cancer. Pancreatic cancer also has no specific clinical manifestations and tumor markers, and imaging features are atypical. Stage I pancreatic cancer accounts for only 2.3% to 7% of patients. More than 80% of pancreatic cancer patients can only undergo exploratory or palliative surgery when diagnosed, and only 5%-30% of them can be cured. In addition, it is difficult to differentiate pancreatic cancer from chronic pancreatitis. The incidence of recurrence and metastasis after surgery is early and high. The treatment effect of single radiotherapy or chemotherapy is unsatisfactory and the prognosis is extremely poor. The international academic community in the 21st century has three points of consensus on clinical treatment of cancer: (1) the shift from empirical medicine to evidence-based medicine; (2) the implementation of individualized treatment; (3) the implementation of standardized treatment. There are about 50,000 to 60,000 new cases of pancreatic cancer in China each year, and the lack of uniform standards for diagnosis and treatment in various units makes the results lack comparability. A multicenter collaborative system for pancreatic cancer should be established in China to develop unified diagnostic criteria and treatment procedures and a unified evaluation system to bring pancreatic cancer research into a standardized track. Early diagnosis is the key should push the early diagnosis of pancreatic cancer to the subhealthy population for screening. If PCR amplification method is used, it can rapidly detect 75% to 93% of mutations with 100% sensitivity; telomerase activity can be detected in 95% of pancreatic cancer patients, while only a small amount can be detected in pancreatitis patients and not in normal human pancreas. Serum and genetic markers for pancreatic cancer have not yet been available as a marker. Combined testing of multiple markers can improve the positive diagnostic rate, such as the triple test. There are many different imaging techniques: color ultrasonography, CT, spiral CT, MRI, ultrasound endoscopy (EUS), and ultrafast magnetic resonance imaging (UMRI), which is significantly more effective than CT and MRI. Others are: ductal endoscopic ultrasound (IDUS): the detection rate of small pancreatic cancer is almost 100%. Laparoscopic ultrasound (LUS): the accuracy of determining positive or negative tumor is 97% and 96%, respectively. Transoral pancreatic ductoscopy: It can detect in situ cancer that cannot enter the branches of the pancreatic duct and is easily missed. Positron emission tomography (PET): It can detect lymph nodes and small liver metastases that cannot be detected by CT and endoscopic US, and differentiate from chronic pancreatitis. The treatment results vary greatly for pancreatic cancer treatment using a single surgery, radiotherapy and a single chemotherapy have failed to achieve satisfactory results, at present, surgery is still the mainstay, the 5-year survival rate of small pancreatic cancer without lymph node metastasis is 23%, but the majority of pancreatic cancer larger than 2 cm has a 5-year survival rate almost equal to zero after surgery. Therefore, the involvement of chemotherapy and radiotherapy must be considered. Preoperative radiotherapy is more sensitive and can improve the completeness of surgical resection and reduce tumor spread. Intraoperative radiotherapy uses a single high-dose irradiation, with necrosis of the tumor center, tissue degeneration, and tumor shrinkage. The average survival of unresected tumors after intraoperative radiotherapy is 9 months, and there are also pain-relieving effects. The median survival of patients with postoperative multifield continuous or multifield segmental irradiation is 4 to 16 months. Several hollow source tubes can be placed intraoperatively for unresected tumors and led out of the abdominal wall, and postoperative inter-tissue irradiation can be done with a post-mounted brachytherapy machine. From 1986 to 1997, 53 cases of advanced pancreatic cancer were treated with radiation at the Cancer Hospital of the Chinese Academy of Medical Sciences, with a median survival of 6 months. Perioperative chemotherapy was systemic and regional chemotherapy. It can be divided into preoperative chemotherapy and postoperative chemotherapy in terms of the timing of drug administration. The combination has better near-term efficiency than single agent, but has no significant effect on survival and increases toxicity. The efficacy of regional chemotherapy, which involves intra-arterial injection of anticancer drugs into the blood supply of the pancreas by cannulation, is still under investigation. Most of the reasons for the failure of chemotherapy in pancreatic cancer are related to drug resistance, and research on the mechanisms of drug resistance and strategies for reversal has been initiated. In addition, biological therapy and gene therapy are still in the exploration stage. In summary, the diagnosis and treatment of pancreatic cancer requires multidisciplinary collaboration such as biochemistry, immunology, imaging, endoscopy, and histocytology, in addition to surgery, internal medicine and radiotherapy departments. In the current pancreatic cancer diagnosis and treatment strategy strongly advocated at home and abroad, special emphasis has been placed on screening of the subnormal population and follow-up of the screened out high-risk group, and the five-year survival rate of patients with stage I pancreatic cancer diagnosed early has been significantly improved after the above-mentioned treatment.