**2. Sporadic pancreatic cancer development**

Pancreatic carcinogenesis begins with the transformation of pancreatic cells and evolution of the precancerous lesions (precursors). At present, six precursors with different morphologies and malignant potential are distinguished [serous microcystic adenoma (SMA); intraductal papillary mucinous neoplasm (IPMN); intraductal tubulopapillary neoplasm (ITPN); mucinous cystic neoplasm (MCN); pancreatic intraepithelial neoplasm (PanIN); and solid pseudopapillary neoplasm (SPN)] [3, 4]. The development of SPC based on the gradual accumulation of genetic and epigenetic alterations consists of three stages: (1) time prior to the invasive lesion, (2) time to the development of the metastatic subclone, and (3) time period of metastatic dissemination that leads to patient death. The average duration of the first two time periods is estimated to be about 18 years. Early detection must be concentrated during these two periods, when patients are often without any symptoms [5].
