· Executive Brief
National Pancreatic Cancer Awareness Month 2026
A practical executive framework for access, ownership, handoffs, measurement, and improvement.
Leadership signal
National Pancreatic Cancer Awareness Month can serve as an executive operating checkpoint.
Awareness can generate questions and requests for help. Executive teams can prepare by clarifying the first point of contact, the qualified team that accepts the request, the handoff standard, and the method used to verify completion without assuming that one route fits every person.
Start by distinguishing what is known from what the organization still needs to learn. A campaign plan, communication volume, or meeting count does not establish that a route is usable. Leaders need direct listening, clear ownership, locally defined measures, and a method for keeping exceptions visible.
Executive opening
Pancreatic cancer tests whether a system can move quickly and stay coordinated
Pancreatic cancer leaves little room for slow handoffs. A review of endoscopic ultrasound noted that merely 10% to 20% of patients are diagnosed at an early stage, and most present with advanced disease.[15] In a national registry cohort of 162,783 patients, five-year overall survival was 8.8% for White patients, 8.2% for Black patients and 10.7% for patients of other races.[10] In a disease this aggressive, each week between suspicion, staging, decision and first treatment carries weight.
The executive problem is that the best-supported care usually depends on several services acting as one. In a two-state registry study, only 22.6% of patients with localized pancreatic cancer received optimal care, defined as guideline-concordant treatment started within 60 days of diagnosis.[4] Patients who received optimal care had a hazard ratio for death of 0.46 compared with those who received the least optimal care.[4] The study was observational, but it points leaders toward treating timeliness and concordance as one measure.
Access is also uneven by place, insurance and race. About 127,519,167 people, or 38.3% of the U.S. population, lived outside 90-minute drive-time areas around high-volume pancreatic surgery centers.[14] Among insured adults aged 65 and older, only 56.3% received stage-specific guideline-concordant care.[1] These are system results, produced by referral patterns, scheduling capacity, coverage and coordination rather than by any single clinician.
National Pancreatic Cancer Awareness Month is a sensible point for boards and operating leaders to ask how their own pathway performs. The sections below add peer-reviewed evidence on timeliness, centralization, multidisciplinary care, germline testing, equity and measurement. They sit beside the executive guidance already on this page and give leaders a shared factual base for choosing where to act first. None of it is clinical guidance for individual patients, and treatment decisions remain with qualified clinicians and the people they serve.
Current evidence
What current research shows about burden, treatment gaps and timeliness
Long-term survival remains uncommon even among patients diagnosed before distant spread. In a national hospital-based registry, 51,071 patients with stage I to III disease were eligible for a three-year analysis, and 12,205 (23.9%) survived three years.[9] Compared with chemotherapy alone, surgery with chemotherapy had an odds ratio for survival of 7.12, and surgery alone had an odds ratio of 3.84.[9] Younger age, lower comorbidity and private insurance were also independently associated with survival.[9] The authors call for structural interventions such as insurance expansion and improved access to high-quality centers.[9]
Combined treatment is often not delivered. Among 11,202 adults with nonmetastatic resectable disease, 3,605 (32.2%) underwent surgery alone, while 6,347 (56.7%) received adjuvant chemotherapy.[8] Only 626 (5.6%) received neoadjuvant chemotherapy, and 624 (5.6%) received chemotherapy both before and after surgery.[8] Patients treated with surgery only were older, more often insured by Medicare and more often treated at community, low-volume centers.[8] The authors see opportunities in patient education and enhanced multidisciplinary care.[8]
Guideline-concordant care is incomplete even in an insured older population. In a cohort of 12,772 adults aged 65 and older, 56.3% received stage-specific guideline-concordant care.[1] Black patients with stage I or II disease were less likely than White patients to receive it, with an odds ratio of 0.66.[1] Dual eligibility, census tract poverty and comorbidities contributed most among measured factors, yet much of the disparity remained unexplained.[1] For an organization, that suggests part of the gap sits in referral, coordination and access processes that registry variables do not capture.
Timeliness appears to matter alongside concordance. The two-state registry study included 100,294 patients.[4] In it, 68.7% of patients with colon cancer and 70.6% of those with non-small-cell lung cancer received optimal care, compared with 22.6% of those with pancreatic cancer.[4] Pancreatic care was the least likely of the three to be both concordant and timely. For leaders, that argues for a pathway measure that asks whether the right treatment began within a defined window, not only whether it happened.
Diagnosis and symptom relief often run through the same procedural service. Endoscopic ultrasound has improved diagnostic accuracy for pancreatic lesions and is increasingly used to relieve malignant biliary obstruction, gastric outlet obstruction and refractory pain in advanced disease.[15] Capacity in that service therefore affects both how quickly patients are staged and how quickly patients with advanced disease receive palliative procedures. When endoscopy schedules are full, early staging and comfort care for advanced disease can be delayed at the same time, so this service belongs in any pathway capacity review.
Figure 1
Pancreatic cancer care often falls short of recommended, timely or accessible care
Percent of patients or population meeting the stated condition, as reported in each study. Values are copied from the cited studies [1], [4], [8], [12], [14]; none is estimated.
Data note. These values come from different studies, countries, years and definitions, so this is an indirect comparison; the bars show where pathways fall short, not how one gap compares with another.
Limitation. Each value reflects its own setting and denominator; registry and claims data cannot capture patient preference, performance status or reasons treatment was not given.
Figure data (5 rows)
| Measure | Value | Population, setting and year as reported | Source |
|---|---|---|---|
| Received guideline-concordant treatment within 60 days of diagnosis | 22.6% | Patients with localized pancreatic cancer, California and Texas cancer registries, diagnosed 2006 to 2016 | [4] |
| Underwent surgery alone for resectable disease | 32.2% | 3,605 of 11,202 U.S. adults with nonmetastatic resectable disease, national hospital-based registry, 2010 to 2020 | [8] |
| Population living outside 90-minute drive of a high-volume center | 38.3% | 127,519,167 U.S. residents; high-volume centers defined by minimum volume thresholds, 2017 to 2021 | [14] |
| Received stage-specific guideline-concordant care | 56.3% | 12,772 U.S. adults aged 65 and older with Medicare-linked registry data, 2004 to 2019 | [1] |
| Patients who could be treated in centers failing minimum standards | 21.5% | 3,455 patients undergoing surgery at 29 Italian centers, 2018 to 2021, against national accreditation criteria | [12] |
Continuum of care
Staging, treatment decisions and first therapy form one chain
Each added step in staging can protect patients from unnecessary surgery, but it also adds a scheduling dependency. A systematic review of 15 studies including 7,243 patients examined adding MRI to CT for preoperative staging.[5] Cohort data showed inconsistent effects on time to surgery, from a 5-day reduction to an 8-day increase, with a weighted mean of 5.7 additional days.[5] In case series, the CT-to-MRI interval averaged 9.7 days and the MRI-to-surgery interval 8.7 days.[5] MRI identified additional liver metastases in 2% to 23% of CT-negative patients.[5]
Variation inside a single referral network can be as important as variation between networks. In one UK regional network, 155 patients with borderline resectable or locally advanced disease started neoadjuvant chemotherapy.[11] The median time from decision to treat to first chemotherapy was 64 days.[11] Referral hospitals differed significantly in median time to biliary drainage and endoscopic ultrasound, and the share of patients started on one standard regimen ranged from 0% to 100%.[11] The authors call for centralized tracking of these patients and locally agreed treatment protocols.[11] Variation of that size suggests a network that shares a goal but not yet a standard.
Care split across institutions does not have to fail. At one high-volume surgical center, 124 of 329 eligible patients received upfront chemotherapy elsewhere before surgical evaluation.[7] These patients lived farther away, a median of 80 versus 32 miles.[7] Fragmented care was not associated with lower resection rates or long-term survival, and the hazard ratio of 0.79 was not statistically significant.[7] The authors note that shared care can ease the burden of frequent travel for systemic therapy.[7]
Together these studies describe a continuum in which the critical risk is waiting between owners. A test is ordered but not scheduled, a decision is made but chemotherapy does not start, or a community oncologist and a surgical center hold different views of the timeline. Executives can treat the interval from first diagnostic imaging to first treatment as a single tracked episode, with each segment visible to both sending and receiving teams.
The chain continues after treatment begins. For patients with advanced disease, endoscopic procedures that relieve biliary obstruction, gastric outlet obstruction and pain are part of the same continuum.[15] Handoffs from oncology to procedural and palliative teams deserve the same tracking and acknowledgment as the handoff into surgery. Early attention to symptom relief is an access question as much as a clinical one.
Figure 3
Why the pathway breaks
People
- No named owner tracking patients between diagnosis and first treatment
- Limited genetic counseling capacity for variant results
- Multidisciplinary review time not protected
Process
- Long interval from decision to treat to first chemotherapy
- Staging tests scheduled sequentially rather than in parallel
- Referral to high-volume surgery not made or made late
Technology
- Records and imaging not shared across institutions in split care
- No shared tracking list across a referral network
- Outreach that depends on Internet access
Environment
- Long travel distances to high-volume centers
- Rural and socially vulnerable communities outside service areas
- Limited endoscopic ultrasound and drainage capacity
Policy
- Uninsured and Medicaid patients less likely to receive therapy
- Referral agreements based on volume labels rather than outcomes
- No locally agreed treatment protocols within networks
Measurement
- Timeliness and concordance tracked separately
- Results not stratified by race, insurance or geography
- Partner center outcomes not reviewed
Unranked qualitative cause-and-effect diagram for the outcome in the box: Patients with pancreatic cancer do not start guideline-concordant treatment within a timely window at an appropriate center Causes are assembled from the cited literature [1], [3], [4], [6], [7], [11], [12], [13], [14]; categories are not weighted and their order carries no meaning.
Data note. Qualitative; no frequencies are implied.
Limitation. Causes drawn from published studies may not all apply locally; validate them with frontline teams.
Figure data (6 rows)
| Category | Causes drawn from the cited literature |
|---|---|
| People | No named owner tracking patients between diagnosis and first treatment; Limited genetic counseling capacity for variant results; Multidisciplinary review time not protected |
| Process | Long interval from decision to treat to first chemotherapy; Staging tests scheduled sequentially rather than in parallel; Referral to high-volume surgery not made or made late |
| Technology | Records and imaging not shared across institutions in split care; No shared tracking list across a referral network; Outreach that depends on Internet access |
| Environment | Long travel distances to high-volume centers; Rural and socially vulnerable communities outside service areas; Limited endoscopic ultrasound and drainage capacity |
| Policy | Uninsured and Medicaid patients less likely to receive therapy; Referral agreements based on volume labels rather than outcomes; No locally agreed treatment protocols within networks |
| Measurement | Timeliness and concordance tracked separately; Results not stratified by race, insurance or geography; Partner center outcomes not reviewed |
Access
Centralization improves results but lengthens the route for many patients
Pancreatic surgery is concentrated in relatively few hospitals. Among 832 centers performing pancreatic cancer surgery for Medicare patients, 76 (9.1%) met minimum volume thresholds and qualified as high-volume centers.[14] Those centers performed a median of 51.1% of all resections in any given year.[14] Over the study period, high-volume centers performed a median of 70.5 pancreatectomies, compared with 5.0 at low-volume centers.[14] The geography of that concentration matters, because about 38.3% of the population lived outside 90-minute drive-time areas around them.[14]
The people outside those service areas are not a random group. Areas with more Hispanic residents (odds ratio 0.86), veterans (odds ratio 0.62) and households without Internet access (odds ratio 0.78) were less likely to be in a high-volume service area.[14] The authors conclude that these individuals mostly belong to rural, socially vulnerable communities.[14] For a health system, that means referral and travel support are part of surgical quality, not a separate social service.
Waiting for a high-volume center appears to be a reasonable trade. Among 15,310 patients undergoing upfront surgery, 5,712 (37%) waited more than 28 days at high-volume centers, defined as 20 or more resections per year.[6] Another 9,598 (63%) had surgery within 14 days at low-volume centers.[6] In unadjusted analysis, five-year survival was 23% in the longer-wait, high-volume group and 19% in the shorter-wait, low-volume group.[6] The authors say these findings assuage concerns about longer waits under centralization.[6]
Volume is still not the same as quality. In an Italian study of 3,455 patients at 29 centers, 90-day mortality among resected patients was 5.3% at medium-volume, 5.1% at high-volume and 3.4% at very-high-volume centers.[12] Under national accreditation criteria, 21.5% of patients could be treated in centers that fail minimum standards.[12] An additional 5.9% received care in high-volume centers where 90-day mortality still exceeded 5%.[12] Referral agreements should therefore rest on reported outcomes, not on volume labels alone.
Access planning can combine two goals that sometimes seem to compete. Higher surgical volume is associated with better outcomes,[6] while local delivery of chemotherapy can reduce the burden of travel.[7] The fragmented care study suggests that shared models can work when timelines stay aligned.[7] A system that sends patients elsewhere for surgery can still own the coordination, travel planning and return to local care that surround the operation. Leaders can ask partner centers for agreed response times on referrals and for a shared timeline that both teams can see.
Executive guidance · System route
Build one visible operating route for National Pancreatic Cancer Awareness Month.
Use this route as a discussion framework. Replace each stage with the organization’s approved process, qualified roles, current service capacity, and applicable requirements. Do not infer a clinical protocol from the observance title.
The route at a glance
- Listen
- Clarify entry
- Navigate across services
- Protect transitions
- Verify and learn
Reliability rule: Every stage needs a named owner, an observable status, an approved escalation path, and a defined signal that shows whether responsibility moved or remained unresolved.
Listen
Gather questions and friction points from people using the route, frontline teams, and community-facing staff. Separate observed barriers from assumptions.
Clarify entry
Publish a plain-language first step and identify who receives requests through each approved channel.
Navigate across services
Make the receiving service, required information, current status, and next accountable owner visible whenever the route crosses an organizational boundary.
Protect transitions
Use acknowledgment and status visibility when responsibility moves between services, locations, or organizations.
Verify and learn
Review unresolved work, repeat contacts, and avoidable handoffs. Use the findings to improve the route rather than blame individuals.
Figure 2
The system route as one flow
The five stages of the system route described in this brief, drawn as one flow with a learning loop back to the start. The stages are the page’s original executive guidance, not a clinical protocol.
Data note. Shows sequence and handoffs only; it carries no counts or rates.
Limitation. Local processes may add, merge or reorder stages under organizational policy.
Figure data (5 rows)
| Stage | What the stage requires |
|---|---|
| Listen | Gather questions and friction points from people using the route, frontline teams, and community-facing staff. Separate observed barriers from assumptions. |
| Clarify entry | Publish a plain-language first step and identify who receives requests through each approved channel. |
| Navigate across services | Make the receiving service, required information, current status, and next accountable owner visible whenever the route crosses an organizational boundary. |
| Protect transitions | Use acknowledgment and status visibility when responsibility moves between services, locations, or organizations. |
| Verify and learn | Review unresolved work, repeat contacts, and avoidable handoffs. Use the findings to improve the route rather than blame individuals. |
Equity and trust
Disparities appear in who is treated, how quickly and where
Disparities in pancreatic cancer show up as gaps in treatment and timing as well as survival. In a Louisiana registry study of 8,466 patients, non-Hispanic Black patients with nonmetastatic disease experienced a significantly longer time to treatment than non-Hispanic White patients.[13] Among patients with metastatic disease, uninsured patients and those with Medicaid had the highest odds of not receiving therapy.[13] The authors call for investigation of the multi-level determinants behind these gaps.[13]
Insurance appears across these studies as a recurring factor. Private insurance was independently associated with three-year survival in the national cohort with stage I to III disease.[9] Surgery-only treatment was more common among Medicare-insured patients in the resectable-disease cohort.[8] Financial counseling and coverage navigation at diagnosis are therefore equity tools as well as revenue functions.
National data show a similar pattern. In a cohort of 162,783 patients, median overall survival was 6 months for White patients, 5 months for Black patients and 6 months for patients of other races.[10] Black patients had worse overall and cancer-specific survival, and the difference was only partly explained by lower surgical receipt and socioeconomic differences.[10] The unexplained portion matches the guideline-concordance study, in which much of the Black-White gap could not be attributed to measured factors.[1]
Where patients live also shapes whether they reach surgery. Among 9,180 Medicare beneficiaries with stage I to III disease, 40.1% received curative-intent surgery, and adjusted rates ranged from 22.0% to 50.4% across 120 Health Service Areas.[2] Lower odds of surgery were associated with older age, lower socioeconomic status, Black and American Indian or Alaska Native race, rural residence and higher comorbidity.[2] The authors attributed 43.0% of the variance in surgery to unmeasured factors, 13.2% to patient-level factors and 6.3% to regions.[2]
For executives, the practical implication is that equity work in pancreatic cancer belongs inside the treatment pathway. Leaders can stratify time to treatment, multidisciplinary review and concordant care by race, ethnicity, insurance, geography and language. They can review unexplained gaps with community partners and patients rather than assume a single cause. Trust grows when a system can show patients that the same pathway is offered, and completed, regardless of who they are or where they live. Equity reviews should also include the patients who never reach a treatment decision, because registry-based measures can miss people lost before referral. A pathway that counts only treated patients will understate the gaps it is meant to close.
Human infrastructure
Genetics, tracking and coordination depend on defined roles
Germline testing shows how workflow design changes access. An estimated 4% to 10% of pancreatic cancers are linked to inherited mutations, and testing guides treatment decisions, yet delays remain common.[3] In one Spanish tertiary hospital, oncologists ordered tests with brief pre-test counseling, followed by nurse-facilitated consent and blood collection.[3] Post-test counseling in a hereditary cancer unit was offered to patients with variants or on request.[3]
The results show both value and workload. Among 223 patients tested, 32 (14.3%) had pathogenic or likely pathogenic variants and 82 (36.7%) had variants of unknown significance.[3] Half of the carriers of pathogenic variants did not meet familial criteria, so familial criteria alone would have missed them.[3] Treatment changed for 7 of 223 patients (3%), and the median time from test request to results was 48 days.[3] Every variant of unknown significance is a conversation that needs a trained person.
Tracking is a role, not a report. The UK network study recommended centralized tracking of patients receiving neoadjuvant chemotherapy, because waits and practices differed sharply between referral hospitals.[11] Someone must own that list, see each patient’s status and escalate when a step stalls. Shared care across institutions likewise depends on staff who exchange records, imaging and treatment plans so that the surgical team can act at the right time.[7]
Diagnostic process varies with center type, which points to differences in team practice. In the Italian study, preoperative histological diagnosis was obtained in 66.6% of cases at very-high-volume centers, 45.7% at medium-volume centers and 23.3% at high-volume centers.[12] The national resectable-disease study identifies enhanced multidisciplinary care as an opportunity.[8] That care requires protected time for the surgeons, oncologists, radiologists, pathologists, nurses and navigators who staff it. Workforce plans should count that time explicitly. When tumor board preparation is treated as unpaid overhead, cases wait for the next available meeting rather than the next clinically sensible one.
Navigation is the connective tissue across these examples. A navigator or nurse coordinator can hold the tracking list and confirm that staging tests are scheduled. The same role can prompt germline testing, arrange travel support and confirm that a receiving team has accepted the patient. Those tasks are easy to describe and hard to sustain without dedicated time, clear scope and caseloads that match referral volume. Leaders should define the role locally and review whether staffing keeps pace with demand.
Executive guidance · Operating dashboard
Use a small dashboard to expose friction and ownership.
Do not publish a number until the organization defines its numerator, denominator where relevant, owner, source system, exclusions, review cadence, and limits. The candidates below are management prompts, not benchmarks or reported results.
Four operating signals
Each signal pairs an executive question with one candidate local measure, set out below.
Executive guidance · Signal
Entry-point clarity
Can people and staff identify the approved first step without searching across conflicting instructions?
- Candidate local measure
- Locally defined contact, routing, and repeat-contact signals by channel and service.
Executive guidance · Signal
Ownership reliability
Does a specific team accept each request and make its status visible?
- Candidate local measure
- Requests without an owner, aged work, transfers, and escalations using locally approved definitions.
Executive guidance · Signal
Navigation continuity
Where does ownership become unclear as people move among information, evaluation, services, and follow-through?
- Candidate local measure
- Locally defined unaccepted handoffs, repeated contacts, missing information, unresolved routes, and navigation feedback.
Executive guidance · Signal
Improvement closure
Does the organization correct recurring friction and report what changed?
- Candidate local measure
- Selected barriers, assigned actions, completion status, and post-change review.
Figure 4
The operating system behind the dashboard
The four operating signals from this brief’s dashboard, each tied to the candidate owner named in the executive scorecard, around one accountable route. Drawn from the page’s original executive guidance.
Data note. Structural diagram; no measured values.
Limitation. Owners are candidates to be confirmed locally.
Figure data (4 rows)
| Operating signal | Candidate owner |
|---|---|
| Entry-point clarity | Executive sponsor and operational lead |
| Ownership reliability | Operational owner and participating teams |
| Navigation continuity | Sending and receiving owners |
| Improvement closure | Improvement owner and executive sponsor |
Executive guidance · Handoff workflow
Close the loop across teams, settings, and partners.
A handoff is reliable only when the sending party knows who is expected to receive the work, the receiving party acknowledges responsibility, and any unresolved exception remains visible. Local policy and qualified judgment control the actual process.
How responsibility moves
Lane A
From message to accepted ownership
- Confirm the approved message and intended audience.
- Publish the actual entry point and receiving role.
- Acknowledge receipt using the locally approved method.
- Escalate when ownership or response remains unclear.
Lane B
From accepted ownership to verified follow-through
- Record the next accountable owner and visible status.
- Name the receiving service and confirm acceptance without promising a clinical determination or outcome.
- Keep unresolved work visible across boundaries.
- Confirm closure or document the continuing exception.
Executive guidance · Executive scorecard
Give leaders one view of route reliability and improvement.
The scorecard keeps review focused on decisions. Leaders should set definitions locally, examine variation without overclaiming cause, and pair quantitative signals with the experience of people who use and operate the route.
Who reviews what
- Executive sponsor and operational lead
- Operational owner and participating teams
- Sending and receiving owners
- Improvement owner and executive sponsor
Candidate owners named in the scorecard, confirmed locally.
| Operating signal | Executive question | Candidate owner | Suggested review point |
|---|---|---|---|
| Entry-point clarity | Can people and staff identify the approved first step without searching across conflicting instructions? | Executive sponsor and operational lead | At campaign launch and close |
| Ownership reliability | Does a specific team accept each request and make its status visible? | Operational owner and participating teams | At a locally defined cadence |
| Navigation continuity | Where does ownership become unclear as people move among information, evaluation, services, and follow-through? | Sending and receiving owners | At a locally defined cadence |
| Improvement closure | Does the organization correct recurring friction and report what changed? | Improvement owner and executive sponsor | Until action is verified |
Figure 5
Control points for a reliable pancreatic cancer pathway
| Control point | Risk if missing | Owner | Evidence of control |
|---|---|---|---|
| Single tracked episode from first diagnostic imaging to first treatment | Patients wait between owners with no one escalating | Pancreatic cancer program lead and nurse navigator | Tracking list reviewed at a set cadence with aged cases escalated |
| Multidisciplinary review before a treatment decision | Surgery alone or no therapy where combined treatment was appropriate | Tumor board chair | Share of new patients reviewed, with documented plan |
| Referral pathway to outcome-verified surgical centers | Resection at centers with higher postoperative mortality | Chief medical officer and network partners | Partner outcomes reviewed annually against agreed standards |
| Germline testing ordered at diagnosis with counseling route | Missed inherited variants and delayed treatment changes | Oncology service line and genetics team | Testing rate, turnaround time and counseling completion |
| Travel and coverage support for patients far from care | Delayed or forgone treatment for rural and uninsured patients | Patient access director and financial counseling | Support requests, completion and time to treatment for supported patients |
| Stratified reporting of timely concordant care | Disparities persist unseen | Quality committee of the board | Quarterly report by race, ethnicity, insurance and geography |
Control points derived from the cited evidence [1], [3], [4], [7], [8], [11], [12], [13], [14] and this brief’s executive guidance.
Data note. Each row is a control to verify, not a measured result.
Limitation. Owners and evidence of control must follow local policy and applicable requirements.
Public communication
Telling patients and the public what the pathway really offers
Public messages about pancreatic cancer work best when they describe a real route rather than general awareness. Because so few patients are diagnosed early, communication should focus on what happens after a concerning finding: who calls, how fast staging proceeds and where treatment decisions are made.[15] Leaders can test whether published promises match the intervals their own pathway delivers. Messages should also name the first point of contact for patients and for referring clinicians.
Honest communication about trade-offs builds trust. Patients asked to wait for surgery at a distant high-volume center may fear the delay. The national comparison of wait times found that waiting at a high-volume center was associated with better overall survival than earlier surgery at a low-volume center.[6] Clinicians and navigators can explain that evidence while still working to shorten the wait and support travel. Explaining why a wait may be worthwhile, and what the team is doing in the meantime, can reduce the chance that patients seek faster but less experienced care.
Channel choice matters for the people least likely to live near specialty care. Areas with more households lacking Internet access were less likely to be within a high-volume service area.[14] Outreach that relies only on portals or web forms may miss the communities that face the longest routes. Telephone follow-up, community partners and printed materials in the languages patients use can close part of that gap. Referring clinicians in rural practices are also an audience, and they need a simple, reliable way to send a patient and learn what happened next.
Genetic results need especially careful explanation. In the mainstream testing study, more than a third of tested patients received variants of unknown significance.[3] Patients and families need clear language about what such a result does and does not mean. The authors call for further study of psychosocial impact compared with traditional counseling pathways.[3] Results letters, family communication and referral to counseling work best as one workflow with a named owner for follow-up questions.
Transparency is the final form of communication. Boards can ask for stratified reporting on timely concordant care, the combined measure linked to survival in the two-state registry study.[4] Accreditation in Italy offers one model, in which minimum standards make center performance visible.[12] Much of the Black-White gap in concordant care remained unexplained by measured factors,[1] so publishing stratified results, including unexplained gaps, signals that leadership intends to close them.
Executive guidance · 90-day plan
Turn the observance into one sustained operating change.
The time boxes below are a management framework, not a clinical timeline. Adjust them to risk, scope, governance, resources, stakeholder participation, and applicable review requirements.
Ninety days, three moves
- Days 1–30See the current route
- Days 31–60Build the reliable path
- Days 61–90Make the change visible
Days 1–30 · Listen and map
See the current route
- Name an executive sponsor and an operational owner.
- Listen to people using the route and representative frontline teams.
- Map how National Pancreatic Cancer Awareness Month communications connect to real entry points, owners, transitions, and escalation.
- Select one recurring barrier that the organization can responsibly address.
Days 31–60 · Design and test
Build the reliable path
- Define the trigger, receiving owner, required information, acknowledgment, escalation, and closure signal.
- Validate the design with every sending and receiving team involved.
- Test one cross-service navigation handoff and correct the point where status or ownership becomes unclear.
- Test the route in more than one representative setting or operating period where practical.
Days 61–90 · Implement and verify
Make the change visible
- Launch the redesigned route with a small set of locally defined measures.
- Review unresolved work and recurring friction using a learning approach.
- Correct implementation barriers and record who owns each remaining dependency.
- Report what changed, what evidence was reviewed, and what still requires live oversight.
Figure 6
The 90-day plan on one timeline
The 90-day plan from this brief drawn as a timeline: each action sits in the 30-day window the plan assigns it. The full wording of each action is in the figure data and in the plan above.
Data note. Time boxes are a management framework, not a clinical timeline.
Limitation. Durations are uniform 30-day windows; real tasks may span windows.
Figure data (12 rows)
| Window | Action |
|---|---|
| Days 1–30 · Listen and map | Name an executive sponsor and an operational owner. |
| Days 1–30 · Listen and map | Listen to people using the route and representative frontline teams. |
| Days 1–30 · Listen and map | Map how National Pancreatic Cancer Awareness Month communications connect to real entry points, owners, transitions, and escalation. |
| Days 1–30 · Listen and map | Select one recurring barrier that the organization can responsibly address. |
| Days 31–60 · Design and test | Define the trigger, receiving owner, required information, acknowledgment, escalation, and closure signal. |
| Days 31–60 · Design and test | Validate the design with every sending and receiving team involved. |
| Days 31–60 · Design and test | Test one cross-service navigation handoff and correct the point where status or ownership becomes unclear. |
| Days 31–60 · Design and test | Test the route in more than one representative setting or operating period where practical. |
| Days 61–90 · Implement and verify | Launch the redesigned route with a small set of locally defined measures. |
| Days 61–90 · Implement and verify | Review unresolved work and recurring friction using a learning approach. |
| Days 61–90 · Implement and verify | Correct implementation barriers and record who owns each remaining dependency. |
| Days 61–90 · Implement and verify | Report what changed, what evidence was reviewed, and what still requires live oversight. |
Executive guidance · Leadership close
Make National Pancreatic Cancer Awareness Month a starting point, not an endpoint.
Recognition matters. It becomes durable when leaders also listen, clarify the route, support the people operating it, close an identified gap, and report the result without claiming more than the evidence supports.
Leadership commitment
Make ownership visible, test the route, and report what improved.
Executive action kit · Month observance
Turn National Pancreatic Cancer Awareness Month into accountable action.
A practical executive framework for access, ownership, handoffs, measurement, and improvement.
Leadership focus
Use this observance to examine navigation, longitudinal ownership, and specialty-care coordination. Select one verified barrier, assign an accountable owner, and carry the improvement beyond the campaign window.
Workforce lens
Ask whether staffing, role clarity, training, tools, workload, and escalation support the people operating the information, diagnostic navigation, support, and follow-through pathway.
Patient and community lens
Make the approved first step clear. Test whether a person can move from information to an acknowledged next action without navigating conflicting instructions.
Equity and access lens
Review whether language, transportation, cost, digital access, disability, geography, or trust changes a person’s ability to complete the locally approved route.
Five-minute briefing
Inspect the operating sequence
Listen with people using the pathway, caregivers, navigation teams, clinical services, and community partners. Find one a confusing entry point, unowned transition, or unresolved navigation need, then test the locally approved route from entry through acknowledged follow-through.
- Listen
- Clarify entry
- Navigate across services
- Protect transitions
- Verify and learn
Leadership actions for this week
- Name an executive sponsor and frontline operating owner.
- Ask people using and operating the pathway where ownership becomes unclear.
- Test one representative route from first question to acknowledged next step.
- Select one barrier that can be corrected without overstating the evidence.
- Set a review date and define how completion will be verified.
Candidate measures
Define every numerator, denominator where relevant, owner, data source, exclusions, cadence, and limitation locally. These are management prompts, not external benchmarks.
- Locally defined contact, routing, and repeat-contact signals by channel and service.
- Requests without an owner, aged work, transfers, and escalations using locally approved definitions.
- Locally defined unaccepted handoffs, repeated contacts, missing information, unresolved routes, and navigation feedback.
Department readiness checklist
- The public and staff entry points match the actual approved process.
- A specific role accepts each request, referral, or escalation.
- Handoffs include acknowledgment and a visible unresolved state.
- Language, disability, digital, transportation, and trust barriers receive explicit review.
- Communications do not introduce unsupported themes, statistics, or clinical advice.
- A named leader will review what changed after the observance.
Intended audiences
- Executive and Operational Leaders
- Patient Experience and Access Leaders
Staff communication template
During National Pancreatic Cancer Awareness Month, our organization will connect awareness with a practical review of the information, diagnostic navigation, support, and follow-through pathway. Use approved information, identify the correct entry point, confirm ownership when work moves, protect privacy, and escalate unresolved barriers through local channels.
Community communication template
National Pancreatic Cancer Awareness Month is an opportunity to share trustworthy information and make the next step easier to find. Use our approved channels for information and support. If a request changes hands, our goal is to keep ownership and follow-through visible.
Measurement worksheet
- Signal
- What observable condition will show whether the route works?
- Definition
- What is included, excluded, and counted?
- Owner
- Who reviews the signal and acts on exceptions?
- Cadence
- When will leaders review it?
- Equity check
- Which differences require protected, locally appropriate review?
- Closure
- What evidence will confirm the improvement was completed?
- Editorial review
- Completed
- Source records
- 2 listed under Authoritative resources
- Review standard
- Sourced facts remain separated from original executive guidance
- Clinical boundary
- No new statistical or clinical claim was added by this action kit
Sources and content boundary
Authoritative resources
Use note: All operating models, measures, scorecard questions, and action steps are original executive guidance. This article supports leadership planning and education. It does not replace clinical judgment, emergency procedures, legal advice, professional standards, organizational policy, or applicable federal, state, and local requirements.
Peer-reviewed references
References
Fifteen peer-reviewed sources, newest first. Each was individually verified through authenticated academic research databases. Bracketed numbers in the text link here; the original executive guidance on this page carries no citations because it is guidance, not a sourced claim. Sources last checked in those databases on .
- 1.Herb J, Liao KP, Lin JK, Lewis KA, Giordano SH, Katz MH, et al. Racial and Ethnic Disparities in Receipt of Guideline-Concordant Pancreatic Cancer Care Among Older Adults in the United States. JCO Oncology Practice. 2026;22(6):1075-1086. https://doi.org/10.1200/op-25-00351
- 2.Liem MNE, Teeken MD, Ruan M, Molina G. Geospatial variation in the treatment of medicare beneficiary pancreatic cancer patients: A SEER-Medicare cohort study. American Journal of Surgery. 2026;251. https://doi.org/10.1016/j.amjsurg.2025.116684
- 3.Bringas M, Echavarría I, Polo C, Jiménez-Alduán N, Flores C, Muñoz A, et al. Mainstream and fast-track genetic testing in pancreatic cancer patients and its impact on treatment: our experience in a tertiary hospital in Spain. Familial Cancer. 2026;25(3):80. https://doi.org/10.1007/s10689-026-00595-8
- 4.Khan MS, Leonard T, Williams N, Mallick S, Meier J, Murimwa GZ, et al. Combined Association of Time to Treatment, Guideline Concordance, and Neighborhood Vulnerability with Localized Colon Cancer, Non-small-cell Lung Cancer, and Pancreatic Cancer Survival. Annals of Surgical Oncology. 2026;33(8):7386-7395. https://doi.org/10.1245/s10434-026-19760-5
- 5.Memon M, Chatzielefthreiou E, Kowal MR, Shapey I, Albazaz R, Smith A, et al. The impact of MRI on real-world staging pathways and management timelines in pancreatic cancer: A systematic review. European Journal of Surgical Oncology. 2026;52(6):111779. https://doi.org/10.1016/j.ejso.2026.111779
- 6.Sakowitz S, Yamashita M, Hammons M, Donahue TR. Improved Survival with Delayed Surgery at High-Volume Centers Versus Early Surgery at Low-Volume Centers for Pancreatic Cancer. Annals of Surgical Oncology. 2026;33(5):4049-4060. https://doi.org/10.1245/s10434-025-19052-4
- 7.Quinn PL, Gutta G, Cloyd JM, Dillhoff M, Pawlik TM, Ejaz A. Fragmented Care for Pancreatic Cancer Patients at a High-Volume Surgical Center. Journal of Surgical Research. 2026;321:500-507. https://doi.org/10.1016/j.jss.2026.03.035
- 8.Johnson J, Erstad D, Reyes JEM, Silberfein E, Buren GV, Fisher W, et al. Missed Opportunities for Multimodality Therapy in Resectable Pancreatic Cancer: National Disparities and Consequences for Survival. Journal of Surgical Oncology. 2026:jso.70408. https://doi.org/10.1002/jso.70408
- 9.Pieri J, Day C, Spaulding A, Tice M, Thiels CA, Fong ZV, et al. Disparities in Pancreatic Cancer Survival: The Overlooked Role of Demographic and Socioeconomic Factors. Journal of Surgical Oncology. 2026:jso.70377. https://doi.org/10.1002/jso.70377
- 10.Dhali A, Mandal S, Asad M, Biswas J, Maji M. Racial Disparities in Pancreatic Cancer. American Journal of Clinical Oncology. 2026. https://doi.org/10.1097/coc.0000000000001328
- 11.Labib P, Alarabiyat M, Powell-Brett S, Hall L, Rehman S, Edwards D, et al. Intranetwork variation in neoadjuvant therapy delivery for borderline resectable and locally advanced pancreatic cancer: a UK multicentre cohort study. The Annals of The Royal College of Surgeons of England. 2026:rcsann.2026.0023. https://doi.org/10.1308/rcsann.2026.0023
- 12.Crippa S, Belfiori G, De Stefano F, Balzano G, Ardito F, Barberis A, et al. Pancreatic cancer surgery in Italy: an updated snapshot from a national multicentre analysis of outcomes by hospital volume. Updates in Surgery. 2026. https://doi.org/10.1007/s13304-026-02813-5
- 13.Galatas A, Malinosky HR, Chapple AG, McManus S, Byerley A, Littlefield E, et al. Multimodal Care and Outcomes of Pancreatic Cancer Patients Are Influenced by Factors Beyond Biology: A Population-Based Study From Louisiana Tumor Registry. Journal of Surgical Oncology. 2025;133(3):338-348. https://doi.org/10.1002/jso.70129
- 14.Paro A, Selamawit W, Diaz A, Khalil M, Baron E, Melendez AIF, et al. Distribution of pancreatic cancer surgery centers and spatial access to care. Journal of Gastrointestinal Surgery. 2025;29(10):102186. https://doi.org/10.1016/j.gassur.2025.102186
- 15.Zhang W, Chen J, Zhang W, Xu M. Advances in Endoscopic Ultrasound in Pancreatic Cancer Screening, Diagnosis, and Palliative Care. Biomedicines. 2024;13(1):76. https://doi.org/10.3390/biomedicines13010076
Claim-to-source matrix
What each source supports
Every sourced claim in the new sections maps to the references that support it, the section where it is used, and the limitation a reader should keep in mind. Original executive guidance carries no sources because it is guidance, not a finding.
| Claim group | Sources | Years | Used in | Limitation |
|---|---|---|---|---|
| Burden, early-stage diagnosis and survival | [9] [10] [15] | 2026, 2024 | Current evidence | Registry survival estimates; the early-stage figure comes from a narrative review. |
| Receipt of multimodal and guideline-concordant care | [1] [8] | 2026 | Current evidence | Claims and registry data do not capture patient preference or fitness for treatment. |
| Timely concordant care and survival | [4] | 2026 | Current evidence | Observational two-state registry study; association, not causation. |
| Staging additions and network variation in time to treatment | [5] [11] | 2026 | Continuum of care | Heterogeneous studies, mostly case series; single UK network. |
| Fragmented care across institutions | [7] | 2026 | Continuum of care | Single high-volume center with propensity matching. |
| Spatial access to high-volume centers | [14] | 2025 | Access | Drive-time modeling with Medicare data; area-level characteristics. |
| Wait time, volume and outcomes | [6] [12] | 2026 | Access | Registry survival associations, unadjusted and adjusted; Italian data may not generalize to U.S. systems. |
| Racial, insurance and geographic disparities | [1] [2] [10] [13] | 2026, 2025 | Equity and trust | Much of the disparity remains unexplained by measured factors. |
| Mainstream germline testing workflow | [3] | 2026 | Human infrastructure | Single-center retrospective descriptive study in Spain. |
| Communication, transparency and accreditation | [3] [6] [12] [14] | 2026, 2025 | Public communication | Communication implications are inferred from access and outcome studies, not tested directly. |
About the author
Greg Wahlstrom
MBAHCM
President and Chief Executive Officer, The Healthcare Executive
View Greg’s profile©2014 – 2026 The Healthcare Executive. All rights reserved.