Many cases present with non-specific symptoms or are asymptomatic until advanced stages of the disease. The following signs and symptoms should be investigated:

• acute pancreatitis where the cause is not alcohol ingestion and gallstones are not evident
• new-onset diabetes
• jaundice that is progressive, together with unexplained weight loss and abdominal pain that may radiate to the back (the jaundice may also be accompanied with dark urine, light-coloured stools and itchy skin)
• pain, which is often severe, unrelenting and of a short duration
• unexplained weight loss
• pale and greasy stools
• nausea and vomiting
• constipation
• fatigue
• enlargement of gall bladder
• blood clot in the leg without a clear risk factor
• incidental lesions found on radiology (Freelove & Walling 2006; Kamisawa et al. 2016).

The presence of multiple signs and symptoms, particularly in combination with other underlying risk factors, indicates an increased risk of pancreatic cancer.

Increasingly, incidental diagnosis may occur with pancreatic abnormalities detected on investigation for other complaints.

The incidence of pancreatic cancer in people below 40 years is extremely low. The cause of jaundice in people aged under 40 years is more likely to be caused by other conditions such as alcoholism or hepatitis. People aged under 40 years with jaundice should be referred to non–cancer related pathways.