Pancreatic cancer in adults: diagnosis and management

Context

Pancreatic cancer is the fifth most common cause of cancer death in the UK, with an annual incidence of nearly 9,600. On average, 23 people die each day from the disease. The UK has one of the worst survival rates in Europe, with average life expectancy on diagnosis just 4 to 6 months and a relative survival to 1 year of approximately 20%.

Only 3% of people survive for 5 years or longer. This figure has not improved much in over 40 years, and it is not yet clear how the more recent trend of increased surgery and adjuvant chemotherapy will affect survival.

Because of late diagnosis, only approximately 8% of people with pancreatic cancer are eligible for potentially curative surgery. However, people have up to a 30% chance of surviving 5 years if their tumour can be surgically removed and they have adjuvant chemotherapy.

The symptoms of pancreatic cancer are non-specific. One survey found that 40% of people diagnosed with pancreatic cancer in England had visited their GP 3 or more times before the diagnosis was made. Fifty per cent of people are diagnosed as an emergency in A&E. Even after diagnosis, there is evidence from the National Cancer Intelligence Network of wide variation in practice throughout England.

There are often delays in access to diagnosis and treatment (as highlighted in the NHS England Five Year Forward View), and this guideline will help to improve this.