A snapshot of pancreatic cancer care

Thanks to the campaigning of our supporters, in 2022 we secured an annual audit of pancreatic cancer data, called the National Pancreatic Cancer Audit (or NPaCA). It is run by the National Cancer Audit Collaborating Centre (NATCAN), which assesses NHS cancer care across England and Wales.

Below we share some key findings and recommendations from NPaCA’s third State of the Nation report published on 10th September 2026.

The report shows that there has been devastatingly little progress for the 10,000 people are diagnosed with pancreatic cancer in England and Wales each year.

Many people are diagnosed at a later stage. People are waiting too long for treatment: far longer than even the NHS’s recommended 62 days. And many people are still not getting the level of support they need to stay fit enough to receive targeted treatment, or to maintain a good quality of life.

Emergency presentation is leading to worse outcomes

For the first time, the audit explores people’s experiences of pancreatic cancer diagnosis and treatment by route to diagnosis. This means the route through which a person is diagnosed with cancer such as GP referral, emergency presentation or secondary care (for example in the hospital).

People diagnosed through an emergency admission were diagnosed on average after just one day. However, they experienced worse outcomes.

In England, people who were diagnosed following a referral from emergency care were less likely to receive treatment (29%) than those diagnosed following referral from GP or secondary care (43%).

This adds to the evidence that emergency diagnosis is associated with poorer outcomes, with people diagnosed at a late stage and receiving fewer treatment options.

Treatment waits remain a major concern

People with pancreatic cancer in England continue to wait on average 78 days for treatment following diagnosis, and 84.5 days in Wales. Variation exists in these waiting times across England and Wales.

This represents no change in England, and a small improvement of 5 days in Wales compared to last year’s report but is still far too long for people with pancreatic cancer and continues to miss the NHS’s 62-day target for treatment.

NPaCA urges cancer alliances in England and Health Boards in Wales to identify potential bottlenecks in pancreatic cancer diagnostic and treatment pathways and review them. We will encourage and support health bodies to implement this recommendation.

Increase in chemotherapy or radiotherapy before pancreatic cancer surgery

The latest report shows the number of people being given chemotherapy or radiotherapy before they have surgery (also known as neo adjuvant therapy) has risen every year for the past decade, from 1 in every 17 people, to 1 in every 5 people.

It has been shown that people given treatment pre-surgery have a better chance of survival after surgery, therefore we welcome this promising development.

Many fit patients are not receiving treatment

However, the report shows that even the fittest of patients are not being kept well enough to receive treatment. Among those with advanced (stage 4) pancreatic cancer who were fit when diagnosed, under half received any disease-targeted treatment in both England and Wales.

NPaCA urges health bodies to conduct a review of people who were fit when diagnosed, but did not receive any disease-targeted treatment.

It says people should have access to range of care services to support people to stay well, including those who do not undergo any treatment, including access to a specialist dietitians and oncology services.

However, it highlights that a national shortage of clinical and medical oncologists is having a significant impact on the care of people with pancreatic cancer.

Looking to the future

In response to the challenges we’ve highlighted, there is much work being done to drive improvements to pancreatic cancer pathways.

Health improvement programmes, including the National Pancreatic cancer Audit (NPaCA), our Optimal Care Pathway project and the NHS Getting it Right First Time (GIRFT) programme for pancreatic cancer, have brought clinicians together to identify challenges and build consensus on the solutions to improve pathways.

Early signs of this focus are reflected in this report, including increased use of chemotherapy before surgery, an innovation that could improve survival rates in the future. We’re also seeing growing use of quarterly audit data by health bodies in England and Wales to identify opportunities to improve pancreatic cancer care.

We are now calling for governments in England and Wales to use this data and recommendations to drive up outcomes for people with pancreatic cancer.

In England, we want to see Department for Health and Social Care (DHSC) build on the recent National Cancer Plan and support the delivery of the recommendations from the national audit and Getting it Right First Time programme. While in Wales, we want to see these recommendations taken forward in the upcoming Wales Cancer Strategy. We will also continue to work closely with GIRFT and national audit team to support local health bodies to make improvements and reduce variation across the pathway.

This report has data on pancreatic cancer outcomes in England between 2022 and 2023, and Wales between 2023 and 2024. We hope to be able to report some further areas of progress in the next editions of this report. More information on findings and recommendations can be found in the full report:

National Pancreatic Cancer Audit (NPaCA) third audit report, 2026