Of all common malignancies, pancreatic cancer has the lowest survival rate. According to estimates by the American Cancer Society, in 2004, 31,860 Americans were diagnosed, and 31,270 died from this near universally lethal disease. Unfortunately, only a small minority of patients are diagnosed when the extent of disease is still localized and thus potentially curable. These dismal survival results could be improved by developing successful screening and prevention strategies. Routine screening is not currently suggested for pancreatic cancer; however, there may be a benefit in a select group of patients identified to be at high risk for developing this disease. It is recommended that surveillance be performed on these high-risk individuals in a research setting to allow for the development of a successful detection strategy.