NPaCA FAQs

The National Pancreatic Cancer Audit (NPaCA) evaluates patterns of care and outcomes for people diagnosed with pancreatic cancer in England and Wales. It aims to highlight variations in care and to support NHS services to identify and address areas for improvement.

The NPaCA project team consists of three clinical leads, methodologists, data scientists, a clinical fellow, a project manager and a project coordinator and collectively is responsible for day-to-day operations of the audit. Also involved in the audit are the following key stakeholders: the wider NATCAN family, Healthcare Quality Improvement Partnership (HQIP) (our funders), clinical experts, allied health professionals, patient and public representatives, charities, and representatives from NHS England and the Welsh Government.

All adults (≥18 years of age) diagnosed with malignant neoplasm of the pancreas, extrahepatic bile duct, or ampullary tumours in England and Wales.
The following people are excluded from the Audit:

– Those with pancreatic neuroendocrine tumours (pNETs)
– Those diagnosed by death certificate only
– Those diagnosed outside the country of interest without treatment of interest

Please refer to the NPaCA State of the Nation report Methodology Supplement for the details of how the inclusion and exclusion criteria are applied.

Pancreatic cancer is one of the least survivable cancers, with little improvement in survival over the past 40 years in the UK.  It is also difficult to diagnose and treat, and there is evidence of variation in the care people diagnosed with pancreatic cancer receive, including differences in stage at diagnosis, use of surgery with curative intent, and access to chemotherapy.  These factors highlight the need for a dedicated national audit to better understand current practice and identify where outcomes can be improved.
By analysing patterns and variations in diagnosis, treatment and outcomes, the Audit provides hospitals with clear, meaningful feedback on where care is strong and where improvements could be made. Our findings are made publicly available to support transparency, quality improvement, and better results for people affected by pancreatic cancer.

Please email [email protected] to contact the NPaCA team.

To stay updated with the NPaCA, you are welcome to subscribe to our quarterly produced newsletter by emailing us at [email protected] and and you could also follow the Audit’s social media accounts on LinkedIn National Pancreatic Cancer Audit and Bluesky @npaca-natcan.bsky.social.

The ICD‑10 codes used in the NPaCA are detailed in the State of the Nation Report Methodology Supplement, where they are listed in the appendices.

The quarterly report is published on the second Thursday of every January, April, July and October. The annual State of the Nation report is generally published on the second Thursday of September. To receive the latest updates from the NPaCA, you can subscribe to receive the Audit’s quarterly produced newsletter, by emailing [email protected], and follow the Audit on LinkedIn National Pancreatic Cancer Audit and Bluesky @npaca-natcan.bsky.social. You can also refer to the “Update” tab on the dashboard, which displays the date of the next scheduled release.

The two principal strategies for reporting NPaCA results are:

• Annual reporting: this comprises a ‘State of the Nation’ (SotN) report for NHS Trusts in England and Health Boards in Wales. It allows NHS organisations in England and Wales to benchmark themselves against clinical guideline recommendations and the performance of their peers.
For England, the audit cohort is based on the “Gold Standard” National Cancer Registration Data (NCRD) which is curated by the National Disease Registration Service (NDRS). The information held in the NCRD is compiled from a variety of sources including the Cancer Outcomes and Services Dataset (COSD), Hospital Episode Statistics admitted patient care (HES APC) records, the Systemic Anti-Cancer Therapy dataset (SACT), RTDS and data submitted by pathology laboratories.

For Wales, Welsh cancer registration data is captured through a national system, Cancer Information System for Wales (CaNISC) and the new Welsh Clinical Portal. The audit also received linked datasets of records from the Patient Episode Database for Wales (PEDW) containing information on inpatient and day case activity, and mortality data from the Office for National Statistics (ONS).

• Quarterly reporting: this comprises an online data dashboard for NHS trusts in England only, which is updated quarterly. Data available to the audit for this quarterly report is based on patient-level records from the Rapid Cancer Registration Dataset (RCRD). It presents performance indicators over a three-year time period at quarterly increments, allowing healthcare providers to monitor their performance at regular intervals and track their progress over time. This is currently limited to NHS trusts within England because NATCAN receives Welsh data on an annual, rather than quarterly, basis.