Despite the diagnostic and therapeutic progress, the prognosis of pancreatic cancer has remained unchanged for last 20 years. Late diagnostics is the main reason of very low 5 year survival which is only in up to 2.0 % of patients. In the diagnostic effort of possible pancreatic cancer in an early stage (mainly in the last decade) we are observing a significant progress in research of new efficient biomarkers and diagnostic methods as well. But clinical practise remains unchanged. Nowadays, the stratification of high risk patients with hereditary syndromes and familial pancreatic cancer represents the only systematic way how to diagnose an early stage of pancreatic cancer. Close cooperation with genetic departments is currently conditio sine qua non. At present time, sporadic form of pancreatic adenocarcinoma is not indicated for screening examinations.