Although stratification of patients based on Smad4 (dpc4) is included in the currently recruiting Radiation Therapy Oncology Group (RTOG) 1201 study, the diagnosis of pancreatic cancer is often made on scant biopsy material or cytology, which limits the accuracy of SMAD4 immunohistochemistry [8]. This evidence concerns the gene SMAD4 and familial pancreatic carcinoma.