Pancreatic Cancer Diagnosis In Primary Care

Resource (1) from the United Kingdom recommends :

Pancreatic cancer

1.2.4 Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) for pancreatic cancer if they are aged 40 and over and have jaundice. [new 2015]

1.2.5 Consider an urgent direct access CT scan (to be performed within 2 weeks), or an urgent ultrasound scan if CT is not available, to assess for pancreatic cancer in people aged 60 and over with weight loss and any of the following:


back pain

abdominal pain




new‑onset diabetes. [new 2015]

The full text pdf of Resource (1) discusses the evidence for the above recommendations on pp. 66 – 74 and is worth reviewing. It also discusses the positive predictive value of individual symptoms and combinations of symptoms.

The imaging recommendations of Resource (1) are not those of Resource (2), Pancreatic Adenocarcinoma 2017 NCCN Clinical Practice Guideline in Oncology.

Resource (2) recommends a dedicated pancreatic CT scan (p 17). The MDCT Pancreatic Adenocarcinoma Protocol is reviewed on p 19. An example of The Pancreatic Cancer Reporting Template is on pp. 21 – 24.

Resource (3) from the European Society of Medical Oncology is brief guideline (13 pages) on pancreatic cancer.


(1) Suspected cancer: recognition and referral (378 pages) Full version pdf.  NICE guideline [NG12] Published date: June 2015.

(2) Pancreatic Adenocarcinoma: V1.2017, Feb. 24, 2017. NCCN Clinical Practice Guideline in Oncology.

(3) Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Ann Oncol. 2015 Sep;26 Suppl 5:v56-68. doi: 10.1093/annonc/mdv295.


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