Pancreatic cancer (PC) has a poor prognosis, with a 5-year survival of 3-4%. This is mainly due to late diagnosis because of diffuse symptoms, where 80-85% of the patients are inoperable. Consequently, early diagnosis would be of significant benefit, resulting in a potential 5-year survival of 30-40%. However, new technologies must be carefully evaluated concerning effectiveness and healthcare costs. We have developed a framework for modelling cost and health effects from early detection of PC, which for the first time allowed us to analyse its cost-effectiveness. A probabilistic cohort model for estimating costs and quality adjusted life-years (QALY) arising from screening for PC, compared to a "wait-and-see"-approach, was designed. The test accuracy, Swedish survival and costs by tumour stage, expected life gain from early detection and pretest probabilities in risk groups, were retrieved from previous investigations. In a cohort of newly diagnosed diabetic patient (incidence 0.71%) the incremental cost per QALY gained (ICER) was e13,500, which is considered cost-effective in Europe. Results were mainly sensitive to the incidence with the ICER ranging from e315 to e204,000 (familial PC 35% and general population 0.046%, respectively). This is the first study focusing on clinical implementation of advanced testing and what is required for novel technologies in cancer care to be cost-effective. The model clearly demonstrated the potential of multiplexed proteomictesting of PC and also identified the requirements for test accuracy. Consequently, it can serve as a model for assessing the possibilities to introduce advanced test platforms also for other cancer indications.Early diagnosis has been estimated by the World Health Organization to form the basis for a cure in 30% of all cancer indications (www.who.int/cancer/en/index.html). Although many biomarkers have been suggested to be able to prognosticate and predict disease outcome, very few, if any, has demonstrated enough accuracy to be implemented for screening of high-risk patient groups. 1 However, the technology development in proteomics has, over the last few years, paved the way for new possibilities. The realisation that by identifying signatures, i.e. combination of biomarkers, rather than single biomarkers, have demonstrated enough accuracy for a test focusing on screening and risk assessment of cancer patients. 2,3 This was recently demonstrated by the identification of a biomarker signature in serum that was strongly associated with ductal pancreatic cancer (PC), thus, for the first time indicating the possibility for an improved diagnosis of this indication, otherwise a disease displaying a very poor prognosis. 4 The development and implementation of new technologies in health care is, however, undertaken in a context of uncertainty concerning the effectiveness and resource costs of health care. Therefore, two types of decisions need to be taken: those concerning provision of the services based on the existing information and those concerned with fu...