{"entity":{"id":"idea-pdac-uk-fast-track-diagnosis-to-treatment-pathway","kind":"idea","name":"A fast-track pathway from suspicion to treatment for pancreatic cancer in the NHS, measured from first scan to first treatment","aka":[],"tldr":"Pancreatic cancer grows and spreads quickly, and delays between the scan that finds it, the specialist meeting, the biopsy, the bile duct stent and the first chemotherapy or operation are measured in weeks. The proposal is a dedicated fast-track pathway with a national standard for the interval from first imaging to first treatment, reported by the audit.","summary":"The National Pancreatic Cancer Audit reports intervals along the pathway (referral, diagnosis, multidisciplinary discussion, treatment) and the proportion treated; Pancreatic Cancer UK has campaigned for treatment within a set number of weeks of diagnosis. The clinical logic is that biliary obstruction must be relieved before chemotherapy (stent), tissue is needed before systemic treatment, and fitness declines while patients wait, so a pathway that runs staging CT, endoscopic ultrasound with biopsy and stenting, germline and tumour testing, dietetic and enzyme assessment and the specialist meeting in parallel within a fixed window is what shortens the interval. This is a placeholder for the specific UK figures and targets the UK and NHS page carries; the idea here is the measurement: adopt first imaging to first treatment as the audited interval, set a national standard, and test whether pathway redesign in a region shortens it without lowering the treatment rate.","asOf":"2026-09-24","links":[{"label":"National Pancreatic Cancer Audit (NPaCA)","url":"https://www.natcan.org.uk/audits/pancreatic/"},{"label":"Pancreatic Cancer UK: Unite Diagnose Save Lives 2025 open letter","url":"https://www.pancreaticcancer.org.uk/get-involved/take-action/join-our-campaigns/unite-diagnose-save-lives-2025/"},{"label":"NICE NG85: pancreatic cancer in adults (2018)","url":"https://www.nice.org.uk/guidance/ng85"}],"tags":["pancreatic-evidence"],"related":["idea-pdac-uk-active-treatment-rate-audit-and-target","idea-pdac-new-onset-diabetes-risk-score-pathway"],"cancers":["pancreatic"],"sections":[],"technologies":["ct","germline-testing"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["obstructive-jaundice","biliary-stent","performance-status"],"trials":[],"people":[],"bottlenecks":["b-care-fragmentation","b-early-detection"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A parallel-process fast-track pathway reduces the median interval from first imaging showing a pancreatic mass to first treatment by at least two weeks and raises the proportion of patients fit for combination chemotherapy at the start of treatment.","rationale":"Every week of delay in a cancer with a median untreated survival of a few months matters; the steps are known and can be scheduled together; the audit can measure the interval nationally.","test":"Regional stepped-wedge implementation with the audit's pathway intervals as outcomes, treatment rate and performance status at first treatment as safety and secondary measures.","maturity":"speculative","actor":"policy","cost":"medium","horizonYears":4},"route":"/ideas/idea-pdac-uk-fast-track-diagnosis-to-treatment-pathway/","neighbours":{"idea":[{"id":"idea-pdac-uk-active-treatment-rate-audit-and-target","kind":"idea","name":"Raise the share of UK patients who receive any active treatment, and publish it by trust","route":"/ideas/idea-pdac-uk-active-treatment-rate-audit-and-target/"},{"id":"idea-pdac-new-onset-diabetes-risk-score-pathway","kind":"idea","name":"Run the ENDPAC score on every new diabetes diagnosis after 50 and scan the high scorers","route":"/ideas/idea-pdac-new-onset-diabetes-risk-score-pathway/"}],"cancer":[{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"technology":[{"id":"ct","kind":"technology","name":"CT (computed tomography)","route":"/technologies/ct/"},{"id":"germline-testing","kind":"technology","name":"Germline (hereditary) testing","route":"/technologies/germline-testing/"}],"term":[{"id":"obstructive-jaundice","kind":"term","name":"Obstructive jaundice and biliary obstruction","route":"/terms/obstructive-jaundice/"},{"id":"performance-status","kind":"term","name":"Performance status (ECOG, Karnofsky)","route":"/terms/performance-status/"},{"id":"biliary-stent","kind":"term","name":"Stenting (biliary, oesophageal, airway)","route":"/terms/biliary-stent/"}],"bottleneck":[{"id":"b-care-fragmentation","kind":"bottleneck","name":"Fragmented care and guideline gaps","route":"/bottlenecks/b-care-fragmentation/"},{"id":"b-early-detection","kind":"bottleneck","name":"The hardest cancers are found late","route":"/bottlenecks/b-early-detection/"}],"roadmap":[{"id":"pancreatic-roadmap","kind":"roadmap","name":"Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question","route":"/roadmaps/pancreatic-roadmap/"}]}}