<prompt> Pancreatic Ca is caused by -FasciolaClonorchisParagonimusNone  <response>: In most cases the disease tends to remain low grade and chronic producing only minor symptoms of abdominal distress,intermittent diarrhea and liver pain or tenderness . C.sinensis has been linked to bile duct carcinoma.It is mostly observed in areas where chlonorchiasis is endemic. refer pgno:126 baveja 3 rd edition 