Pancreatic cancer is the fifth leading cause of cancer-related deaths in Japan. Small pancreatic cancers have some abnormal findings on ultrasonography, and diagnosis with endosonography is useful. Positron emission tomography and contrast-enhanced ultrasonography are expected to serve as new modalities for the early detection of pancreatic cancer. The identification of high-risk individuals is necessary to perform efficient screening. Intraductal papillary mucinous neoplasms and chronic pancreatitis are important risk factors for pancreatic cancer.