BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) presents an urgent challenge that necessitates improved early risk identification. We investigated the association between predictors of PDAC present at least two years before diagnosis and PDAC occurence. METHODS: This case-control study used electronic health records from The Health Improvement Network Database (UK). Cases (10,575) were matched with controls (105,750) in a 1:10 ratio by gender, age, follow-up duration, and year of inclusion in the database. Variables included clinical features, comorbidities and blood result abnormalities, reported at least 2 years before PDAC diagnosis or equivalent timeframe for controls. Conditional logistic regression model with backward estimated odds ratios (OR) and 95% confidence interval (CI). RESULTS: Electronic health records of cases reported higher prevalence of alcohol intake, cigarette smoking, dyslipidemia, increased blood pressure, and diabetes of more than four years' duration. Independent risk factors included pancreatic cysts (OR = 4.39), pancreatitis (OR = 2.16), dyslipidemia (OR = 1.50), smoking (OR = 1.09), and alcohol intake (OR = 1.09). Laboratory markers associated with higher risk included elevated alkaline phosphatase (OR = 3.21), bilirubin (OR = 2.48), alanine aminotransferase (OR = 1.76), erythrocyte sedimentation rate (OR = 1.27), and decreased albumin (OR = 1.54). CONCLUSIONS: Primary care electronic records can identify individuals at medium-term increased risk of PDAC, thus raises the opportunity to develop early detection models and address modifiable factors.