Pancreatic Cancer: Late Diagnosis, Slow Survival Gains and the Funding Gap

Pancreatic cancer is the 11th most commonly diagnosed cancer in the world but the 6th most common cause of cancer death: an estimated 531,318 people were diagnosed in 2024 and 490,786 died. Survival has improved, but slowly and from a very low starting point, and most people are still diagnosed after the cancer has spread.

Behind these figures are people who may see their doctor several times before anyone suspects the pancreas, who are often diagnosed after an emergency admission, and who, with their families, then face hard decisions in a short time. This article sets out what the international data show about why survival has moved so little, where the system gaps are, and how research funding compares with the number of lives lost. None of it is a forecast for any one person: the figures describe populations, and every population includes people who do better than its average.

Deaths come close to matching diagnoses, worldwide

GLOBOCAN 2024, the International Agency for Research on Cancer's latest estimates for 186 countries, puts pancreatic cancer at 2.6% of the world's new cancer cases but 5.0% of its cancer deaths.^[1] Among men there were an estimated 280,061 new cases and 258,680 deaths; among women, 251,257 new cases and 232,106 deaths, with age-standardised (world standard) incidence rates of 5.4 and 4.0 per 100,000 respectively.^[1] The number of deaths in a year is more than nine-tenths of the number of new diagnoses that year. That ratio is not a survival rate, because the people who die in a given year were not all diagnosed in it, but it shows how few people currently live long after a diagnosis.

In the United States, the American Cancer Society expects pancreatic cancer to be the third most common cause of cancer death in 2026, after lung and colorectal cancer.^[3] The National Cancer Institute's SEER programme estimates 67,530 new cases in 2026, 3.2% of all new cancers, and 52,740 deaths, 8.4% of all cancer deaths.^[4] Age-adjusted incidence rose by an average of 0.9% a year between 2014 and 2023, while age-adjusted death rates were stable between 2015 and 2024. The median age at diagnosis is 71.^[4]

Europe shows a similar pattern. In annual modelled predictions of cancer death rates for the European Union, based on World Health Organization death certification data, pancreatic cancer has stood out in recent editions as a major cancer whose death rates are not falling. The 2025 predictions expected age-standardised pancreatic cancer death rates to be 2.0% higher in men and 3.0% higher in women than in 2020, against favourable trends for most other major cancers; the authors suggested the persistent trend "can be related to the increasing prevalence of obesity and limited therapeutic advances", with obesity an association, not a proven cause.^[5] The 2026 predictions again found favourable trends for most major cancers "except female pancreatic cancer".^[6] These are projections from recent trends, not counts.

Survival has risen more than fourfold in the US, but from a very low base

In the longest-running US registry series (SEER 8), five-year relative survival from pancreatic cancer rose from 3.2% for people diagnosed in 1975 to 14.4% for those diagnosed in 2018, a more than fourfold improvement.^[4] These are observed values for single years of diagnosis and move from year to year, so the direction is more certain than the exact ratio. In the wider SEER 21 registries, five-year relative survival for people diagnosed in 2016 to 2022 was 13.7%.^[4] That means that, on these US figures, about one in seven people survive their cancer for five years, once deaths from other causes are allowed for.

The International Cancer Benchmarking Partnership's SURVMARK-2 study, covering seven high-income countries from 1995 to 2014, found that one- and five-year net survival increased in each country for almost all of the seven cancers studied, and that improvements were notably larger for cancers with a poor prognosis, pancreatic cancer among them.^[7] But pancreatic cancer was not among the cancers where survival rose and mortality and incidence fell together, which the authors treated as the clearest sign of progress in cancer control.^[7]

That matters for how survival gains are read. When survival rises but death rates stay flat, as in the US figures above, some of the rise may come from finding cancers earlier in their course without changing when people die (lead-time bias), or from better recording. The data cited here do not separate those effects, and our guide to survival statistics explains them.

A later ICBP analysis looked at pancreatic cancer alone in Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK, for more than 35,000 people diagnosed in 2012 to 2014.^[8] One-year net survival ranged from 21.1% in New Zealand to 30.9% in Australia, and three-year net survival from 6.6% in the UK to 10.9% in Australia. These are countries with comparable wealth and universal health systems, and the gap between them is a reminder that outcomes are not fixed by the disease alone. Our article on survival compared across countries sets these figures beside other cancers.

Source: Cabasag et al., British Journal of Cancer 2022, ICBP SURVMARK-2, seven countries.^[8] Stage recording differs between registries, so the stage shares are not perfectly comparable.

Half or more are diagnosed after the cancer has spread, often in an emergency

Stage at diagnosis goes a long way towards explaining why pancreatic cancer survival is so low. In the US SEER 21 registries, 51% of pancreatic cancers diagnosed in 2016 to 2022 had already spread to distant organs, and only 15% were found while still localised.^[4] Five-year relative survival was 43.6% for localised disease and 3.4% for distant disease. In the seven ICBP countries, the share diagnosed at distant stage ranged from 53.9% in Ireland to 83.3% in New Zealand.^[8] The ICBP authors also found survival differences between countries within every stage group at one year, narrowing with longer follow-up, particularly for distant-stage disease, which suggests that care after diagnosis matters as well as timing.^[8]

How people come to be diagnosed tells the same story. An ICBP study of 857,068 people in 14 jurisdictions across Australia, Canada, Denmark, New Zealand, Norway and the UK, diagnosed between 2012 and 2017, defined an emergency presentation as a cancer diagnosis within 30 days of an emergency hospital admission.^[2] Pancreatic cancer had the highest share of any cancer studied: 46.1% (30,972 of 67,173 people), ranging from 34.1% to 60.4% between jurisdictions. Across several cancers including pancreatic, a 10% higher share of emergency presentations in a jurisdiction was associated with one-year net survival between 2.5% and 7.0% lower.^[2]

Many people do seek help before that point. In England's 2010 National Cancer Patient Experience Survey, analysed for 41,299 people with 24 cancers, 41.3% of people with pancreatic cancer (193 of 467) had seen their GP three or more times before being referred to hospital, compared with 7.4% of people with breast cancer and 10.1% with melanoma.^[9] Repeated visits are a sign of how difficult pancreatic cancer can be to recognise, not of anyone failing to act. Our articles on stage at diagnosis and the route from symptom to diagnosis cover these patterns across cancers.

Where people live and how old they are shape the care they receive

Surgery to remove the tumour is open to only a minority of people, mainly those diagnosed early. Even so, how often it happens varies widely. A study of 153,698 records from six European population-based registries and the US SEER programme found that, for people diagnosed in 2012 to 2014, the age-standardised share who had their tumour removed ranged from 13.2% in Estonia to 21.2% in Slovenia overall.^[10] For people with stage I to II tumours, the group for whom surgery is most often considered, it ranged from 34.8% in Norway to 68.7% in Denmark. Between 2003 and 2014, resection rates rose only in the USA, the Netherlands and Denmark.^[10]

Age made a large difference. Compared with people under 60, the odds of having surgery were between 0.37 and 0.63 times as high for people aged 70 to 79, and between 0.03 and 0.16 times as high for people aged 80 or over, depending on the country.^[10] Between 52.6% and 59.5% of people in the study were aged 70 or over. Some of this is likely to reflect frailty and other illnesses; the size of the variation between countries suggests not all of it does.

Supportive care shows gaps too. Pancreatic cancer can stop the pancreas making enough of the enzymes needed to digest food, and pancreatic enzyme replacement therapy (PERT) is a prescribed medicine that replaces them. UK guidelines recommend it for all people with unresectable pancreatic cancer.^[11] A national audit using the electronic health records of 24 million people in England, including 22,860 people diagnosed with pancreatic cancer, found that the share prescribed PERT rose from 41% in 2015 to 48% in early 2023, against a recommended standard of 100%, with rates of 50% to 60% in the West Midlands.^[11] The authors called for research into the barriers to prescribing. This is a gap in services, measured at population level; it says nothing about what is right for any individual.

Research funding has grown, but still trails far behind deaths

Progress depends on research, and pancreatic cancer has historically received a small share. Among the 120 funding organisations in the International Cancer Research Partnership, mostly government and charity funders in the US, Canada, Europe, Japan and Australia, investment in pancreatic cancer research rose threefold, from US$62 million in 2006 to US$259 million in 2018, and its share of their cancer research investment rose from 1.7% to 4.6%.^[12] That is a real shift, and the authors noted that earlier analysis of the same data had highlighted the role of both government and non-profit funders in building research on this cancer.

Measured against deaths, though, the gap remains wide. A 2026 analysis of US National Institutes of Health (NIH) funding found US$440 million across all active NIH projects on pancreatic cancer in fiscal year 2025.^[13] The authors estimated deaths by multiplying annual new cases (North American Association of Central Cancer Registries data for 2022) by the share of people not surviving five years (SEER 21 registries, 2015 to 2021), giving an estimated 49,211 deaths. That works out at US$8,945 of NIH funding per estimated death from pancreatic cancer, compared with US$69,800 for female breast cancer and US$126,992 for prostate cancer. Per new case, pancreatic cancer in fact received more, US$7,756 against US$5,793 for breast and US$2,667 for prostate; the gap per death opens up because so many more pancreatic cancer diagnoses end in death: the authors' mortality-to-incidence ratio was 0.867, against 0.083 for breast cancer.^[13] The authors concluded that "cancers with the highest lethality receive disproportionately lower levels of federal research support", and noted their own limits: one year of funding data and estimated rather than recorded deaths.

Global analyses raise the same question. A review of public and philanthropic cancer research awards worldwide in 2016 to 2020 found breast cancer was the most highly funded cancer type, and concluded that "cancer research funding must be aligned with the global burden of cancer", with more equitable funding for low- and middle-income countries.^[14] The US authors accept that funding per death is not the only fair yardstick, since scientific opportunity and prevention also matter, but on that measure the cancers with the poorest survival remain at the back of the queue.

What the evidence asks of us

The figures do not support despair, and they do not support complacency. They point to specific gaps that services, funders and policymakers can act on.

• Find it sooner, and count how it is found. With close to half of pancreatic cancers in the ICBP countries diagnosed after an emergency admission, and higher emergency shares linked to lower one-year survival, the routes by which people are diagnosed deserve routine measurement and public reporting in every health system that can collect them.^[2]
• Support primary care to recognise it. When four in ten people with pancreatic cancer in England's survey had seen their GP three or more times before referral, the gap lies in the tools and pathways available to clinicians, not in the people seeking help.^[9]
• Close unexplained variation in treatment. Resection rates for early-stage disease that range from about a third to over two-thirds between European countries, and steep falls with age, call for national audit of who is offered surgery and why.^[10]
• Meet the standards already set. In England, PERT prescribing at just under half against a recommended 100% is a measurable gap that the audit's authors say needs research into barriers, and that services can track.^[11]
• Fund research in line with lives lost. Investment has risen, but US federal funding per estimated death for pancreatic cancer is a small fraction of that for breast or prostate cancer, and the authors of a global review of cancer research funding call for investment to be aligned with where cancer does most harm worldwide.^[13][14]

For more on how pancreatic cancer fits the wider picture, see the Cancer research library.

Language: this piece says "people with cancer" and "people living with and after cancer", and describes the illness and its treatment plainly, without combat metaphors. Clinical terms such as "stage", "incidence" and "net survival" are used in the sense the cited source defines them.

Why we're publishing this

Pancreatic cancer charities and the families they support have spent years making the case that this cancer receives too little attention for the number of lives it takes. The data bear them out: deaths close to diagnoses, survival that remains low despite real gains, diagnosis that too often comes in an emergency, and research funding that still lags far behind mortality. We have gathered the international evidence in one place, with its sources, so that the people making that case can cite it with confidence.

How to read this data

Global figures are GLOBOCAN 2024 modelled estimates for a single year; they are less precise for countries without good cancer registries. Survival figures describe people diagnosed years ago: the SEER five-year figures cover diagnoses in 2016 to 2022 and the ICBP figures diagnoses in 2012 to 2014, so they do not capture any more recent changes in care. SEER reports relative survival and ICBP net survival; both allow for deaths from other causes but are calculated differently, and US and ICBP figures should not be compared directly. Stage definitions and the completeness of stage recording differ between registries. The European mortality figures are projections from recent trends. Resection rates come from registries in a limited set of European countries and the US. The NIH funding comparison uses one year of funding for active projects and deaths estimated from incidence (NAACCR, 2022) and survival (SEER 21, 2015 to 2021), not recorded deaths, and the international funding data cover major funders in high-income countries only. Funding data for many countries, including recent UK site-specific spend, were not available to us at source and are not included. The ratio of deaths to new cases in the opening section is our own calculation from GLOBOCAN figures, not a survival measure.

Use this data

Free to cite with attribution to Better Health For Everyone. Charities, campaigners and journalists are welcome to reuse these figures and charts. For the underlying figures as a spreadsheet, get in touch.

Important: This article summarises published research for general information. It is not medical advice and cannot be used to diagnose, treat or predict anything about an individual. If you have concerns about your own or someone else's health, please speak to a qualified health professional.

Sources

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