The clinical course of patients with pancreatic cancer remains dismal. This may be because the pancreas is a retroperitoneal organ, the symptoms are non-specific, occur late, and pancreas cancer has an invasive nature. Screening for asymptomatic or symptomatic patients using serum tumor markers and ultrasonography is not cost-effective. However, the clinical course of small carcinomas less than 1 cm or 1 cm in size is favorable. Thus, the detection of small pancreatic carcinoma is essential to improve the clinical outcome. Possible discovery of pancreatic carcinoma as a diagnostic clue to diabetes mellitus, and intraductal papillary-mucinous neoplasm are introduced based on our clinical experience.