Pancreas cancer presents late because there is a lack of early symptoms that speak directly to the presence of this disease. And the symptoms that an individual may have are somewhat non-specific. So for example, back pain, decrease in appetite, change in energy level. They could be reflective of a lot of different things and not necessarily specifically point to an underlying diagnosis of pancreas cancer.
The other point that I would make is that this organ, the pancreas, can be difficult to image. So for example, people with abdominal symptoms, often a first test will be an ultrasound. But an ultrasound is not that sensitive or specific. And even a CT or a noncontrast CT cannot be sufficient that you need contrast, and need to be looking very carefully at the pancreas. So a lot of times, things can be overlooked. And I don't mean to imply that that's the major problem, it's not. It's the challenge of the lack of early symptoms and the lack of specific symptoms.