Research & Advocacy

Provincial Pancreatic Cancer Report Card

Evidence assessed to: August 2025
Page last corrected: October 2026

How does Canada respond?

This report card asks a straightforward question: how well do Canada's health systems respond to the needs of people facing pancreatic cancer?

It assesses documented provincial and territorial policies and programs across eight areas: cancer strategy, biomarker testing, drug coverage, clinical trials, timely care, travel support, workforce and patient navigation, and research funding. Its purpose is to identify strengths, gaps and priorities for action.

Published by The Heather Cutler Foundation, the report card draws on research inventories compiled by student researchers through the Pancreatic Cancer Policy Builders of Tomorrow program. The grades represent the Foundation's assessment — not an official government rating or a measure of an individual patient's care.

About this edition

This edition draws on research collected from June to August 2025. It is a historical assessment, not a live directory of available services. Subsequent developments are identified separately to distinguish the original findings from changes made after the research period.

The Foundation is responsible for the final grades, interpretation and publication. Readers should consult the methodology, supporting sources and limitations when interpreting the results.

Before publication, the Foundation reviewed the student inventories and checked the factual claims supporting the grades against the sources identified in the report.

How the grades were developed · Sources & limitations · Report a correction

Headline findings

No jurisdiction has a pancreatic screening program or a dedicated pancreatic program — all 13 record the same result. Pancreatic cancer is managed within general oncology services everywhere, and in several provinces it is not named in the provincial cancer strategy at all.
Research funding is concentrated. Of 88 pancreatic-cancer grants from the Canadian Institutes of Health Research (CIHR) in the register compiled for this research, totalling $23,354,337, six went to Atlantic Canada institutions — all in Nova Scotia, totalling $273,000. Newfoundland and Labrador, New Brunswick, and Prince Edward Island hosted none.
Biomarker testing is two-tier. Ontario operates the benchmark: a publicly funded comprehensive biomarker testing program that rolled out from June 2021 and was implemented province-wide by 2021/22. Within Atlantic Canada, Nova Scotia and New Brunswick have partial in-province capacity, while Newfoundland and Labrador and Prince Edward Island rely on send-out testing and out-of-province referral.
Take-home drug costs fall heavily on Atlantic patients and their private plans (PMPRB, 2021) — see the basis statement in the Atlantic section below.
The longest waits in Canada are in Atlantic Canada. Prince Edward Island recorded a median wait of 77.4 weeks from GP referral to treatment, and Nova Scotia 39.1 weeks (Fraser Institute, 2024). These are all-specialty medians, not pancreatic cancer waits; pancreatic-specific waits are published nowhere the researchers could find.
Travel is a stage of treatment in Atlantic Canada. In the 2025 research period, Atlantic pancreatic surgery was centralized in Halifax and St. John's, trial access in the region was assessed as extremely limited, and existing travel support is largely reimbursement-based, income-tested, or both.

Choose a jurisdiction

Ontario is the strongest system in Canada on this evidence — and it still has no dedicated pancreatic program. Its publicly funded comprehensive biomarker testing program, rolled out from June 2021 and implemented province-wide by 2021/22, is the national benchmark, and its drug coverage combines an income-based cap on out-of-pocket costs (the Trillium Drug Program), a case-by-case Exceptional Access Program, and $0 patient cost for covered in-hospital IV drugs. It is the national concentration point for clinical trials and research funding. Its one unassessed category — provincial travel support — was not documented in the research and is excluded from the mean rather than scored as zero.

Read the full assessment Find patient resources for Ontario

British Columbia's 10-Year Cancer Action Plan (2023–2033) carries an initial $440 million investment through six regional cancer centres, its genomics laboratory holds a provincial mandate for molecular diagnostics for all cancer patients, and the University of British Columbia holds the largest institutional share of the national CIHR register. The province is also a pilot province for decentralized clinical trials. Its drug coverage and timely care could not be assessed from this research; the only patient-cost support documented is a donor-funded charitable relief fund, with no provincial travel program recorded.

Read the full assessment Find patient resources for British Columbia

Nova Scotia is Atlantic Canada's research and treatment hub, and its grade reflects that concentration rather than any pancreatic program, which it does not have. It hosts all six Atlantic CIHR pancreatic-cancer grants ($273,000), in-province sequencing at the QEII Health Sciences Centre, and the Atlantic Clinical Cancer Research Unit, reported with 45–55 trials in start-up and 20–25 active — though regional pancreatic trial access remains "extremely limited." Its province-wide Cancer Patient Navigation Program, in place since the early 2000s, is a documented Atlantic strength. Against that: a median wait of 39.1 weeks from GP referral to treatment (Fraser Institute, 2024), and a travel program income-tested at a $35,000 gross family income threshold documented as excluding many rural residents.

Read the full assessment Find patient resources for Nova Scotia

Care runs through the NL Health Services Provincial Cancer Care Program, with pancreatic and HPB surgery provided in-province at a single centre in St. John's; no NL-specific wait-time figure was obtainable. Testing is the weakest point after research funding: the laboratory formulary funds BRCA1/2 and hereditary colorectal panels under an entry dated 2019 — the oldest in the national inventory — and broader profiling requires send-out testing. The province is a pilot province for decentralized trials, with a satellite research site in Grand Falls–Windsor, and its Medical Transportation Assistance Program cost-shares airfare, mileage, accommodations, and meals, though the up-front payment burden is documented as capable of delaying treatment starts for rural and Labrador patients. No CIHR pancreatic-cancer grant is hosted at a Newfoundland and Labrador institution.

Read the full assessment Find patient resources for Newfoundland and Labrador

The New Brunswick Cancer Network coordinates care, and Horizon Health's pan-cancer testing panel explicitly lists pancreas and is available in-province — partial capacity, but no comprehensive funded program. In the 2025 research period the province had no in-province pancreatic surgery (see the Moncton note above); systemic and radiation therapy are delivered in Saint John and Moncton, and no New Brunswick wait-time figure was obtainable. Horizon has implemented decentralized trials and collaborates formally with Nova Scotia on specialized services and shared trials. Its medical transportation program is rated moderate — "limited coverage scope, basic travel assistance only" — and no CIHR pancreatic-cancer grant is hosted in the province.

Read the full assessment Find patient resources for New Brunswick

Prince Edward Island's Cancer Action Plan 2023–2028 is a current strategy, but the province has no in-province biomarker testing pathway — access runs solely under its out-of-province testing policy — and, in the 2025 research period, no in-province pancreatic surgery, with Whipple-eligible cases typically performed in Halifax. It also carries the longest documented wait in Canada: 77.4 weeks, median from GP referral to treatment across all specialties (Fraser Institute, 2024). Its travel supports are comparatively strong — a Maritime Bus Subsidy and a Hope Air partnership, each rated 4 of 5 by the student assessors. Its workforce and navigation category could not be assessed: PEI-specific policy appears in the research only inside regional analyses.

Read the full assessment Find patient resources for Prince Edward Island

Quebec's cancer plan sets eight strategic axes, its INESSS/RQDM process adds genomic tests and supports testing repatriation, and Montreal is recorded at 34% in the research's trial-activity figures. But the research could not assess its drug coverage, waits and surgical capacity, travel support, or workforce and navigation — four gaps that fall below the five-of-eight threshold, so no overall grade is published.

Read the full assessment Find patient resources for Quebec

What the research could assess was comparatively strong: an operational Cancer Genomics Program, and the lowest measured private-pay share in the country — 12% of take-home oncology medicine spending, against up to 59% in the Atlantic groupings (PMPRB, 2021). Trials, waits and surgery, travel, workforce, and research presence could not be assessed, so no overall grade is published.

Read the full assessment Find patient resources for Alberta

CancerCare Manitoba's strategy "does not explicitly highlight pancreatic cancer," its Molecular Diagnostics Expansion is in effect, and its Indigenous Patient Navigator program and shared-care Community Oncology Program are documented strengths. Drug coverage, trials, surgery and waits, travel terms, and research presence were not covered in the research, so no overall grade is published.

Read the full assessment Find patient resources for Manitoba

Saskatchewan's cancer plan is in operation and the province hosts one major pancreatic-flagged research grant — the University of Saskatchewan's MUC-16 program, $979,200 — but pancreatic cancer "is not highlighted as a distinct focus," and five of eight categories, including drug coverage, trials, and travel, could not be assessed. No overall grade is published.

Read the full assessment Find patient resources for Saskatchewan

Nunavut has no standalone cancer agency; care runs by referral to southern tertiary centres. Its patient travel support programs are documented as significant budget line items, but their terms are not in the research, and the biomarker database holds no territorial entries — only two categories could be assessed.

Read the full assessment Find patient resources for Nunavut

The territory's posture is screening, referral, and community-based supports with reliance on southern tertiary centres, without a consolidated cancer strategy. Only that strategy category could be assessed from this research; the remaining seven were not covered.

Read the full assessment Find patient resources for Northwest Territories

Yukon has no standalone territorial cancer strategy equivalent to a provincial cancer agency, and care runs by referral to British Columbia and Ontario. Only the strategy category could be assessed; the research holds no usable territorial evidence for the other seven categories.

Read the full assessment Find patient resources for Yukon

The territories publish as “Insufficient data — not graded” because the research itself was thin there. That is a finding about the evidence base, and about the reality the grades describe: territorial patients are served entirely through referral to provincial systems.

Overall grades by jurisdiction — letter grade and mean score, with the number of categories assessed. “Not graded” means the evidence was insufficient to grade; missing evidence is never scored as zero.
Jurisdiction	Grade	Mean	Assessed
Ontario	A	3.6	7 of 8
British Columbia	B	2.5	6 of 8
Nova Scotia	C	2.1	8 of 8
Newfoundland and Labrador	C	1.6	8 of 8
New Brunswick	C	1.6	8 of 8
Prince Edward Island	D	1.1	7 of 8
Quebec	Not graded	2.3*	4 of 8
Alberta	Not graded	2.7*	3 of 8
Manitoba	Not graded	2.3*	3 of 8
Saskatchewan	Not graded	2.3*	3 of 8
Nunavut	Not graded	1.0*	2 of 8
Northwest Territories	Not graded	1.0*	1 of 8
Yukon	Not graded	0.0*	1 of 8

* Mean of assessed categories only, shown for transparency. No overall grade is published below the five-of-eight evidence threshold described in the methodology.

What these grades can and cannot tell you

What should change

The recommendations below are the student researchers' own, drawn from their research documents. They are not foundation positions.

Biomarker testing. Set a turnaround-time target of ten working days or fewer for biomarker results, and build an Atlantic coverage baseline using Quebec's INESSS/RQDM processes as a template.
Drug coverage. Adopt take-home cancer drug coverage standards that close the gap with Alberta-level public funding (88%), treating take-home drug coverage and the fragmentation of provincial laboratory formulary systems as critical priorities.
Federal transfers. Move the Canada Health Transfer toward age-adjusted allocation, which the reform strategy projected — as a projection, not an observed figure — could yield more than $200 million annually in additional funding for Atlantic health services.
Travel support. Raise Nova Scotia's travel-assistance income threshold from $35,000 to $50,000 in gross family income, and work toward targets the researchers set: travel distance under 200 km for 90% of patients within three years, and 80% rural broadband coverage within three years.
Collaboration. Extend tri-provincial collaboration models to include Newfoundland and Labrador, particularly for high-burden, low-survival cancers; integrate the Atlantic Clinical Trials Network with the consortium's patient advisory structures, which the researchers ranked the most impactful collaboration gap; and present the Atlantic Cancer Consortium and ACCESS Atlantic as national exemplars for regional collaboration.
Workforce. Add oncology- and diagnostic-specific workforce targets to national and provincial policies, and build retention mechanisms that go beyond initial bonuses and debt forgiveness.
Indigenous cancer care. Place Indigenous patient navigators in each province within eighteen months; mandate explicit cultural-safety standards consistently; and move Indigenous self-determination in cancer planning from partial support toward codified decision rights.
Transparency. Publish the membership composition of the pCODR Expert Review Committee, the gap the advocacy analysis rated most significant.

Looking for care information?

The assessment above is policy evidence. For practical help — contacts, pathways, financial and travel support — use the patient resources:

Find patient resources Guides by province and territory

Methods, sources and downloads

The full source register is published in the report and on the methodology page.

Credits and disclosures

Research: Arafa Hossain, Charlotte Campbell, Grace Fitzgerald, Rayah Vokey, Seriman Doumbia, Chaturrvi Maruthireddy, and Kimia Rezaeinejad, student researchers in the foundation’s Policy Builders of Tomorrow program (Memorial University undergraduates), June–August 2025.

Grades, verification of key figures, and editorial responsibility: The Heather Cutler Foundation. Credit never implies endorsement by any university, hospital, charity, or agency.

This research was conducted by student researchers as part of an educational program. The foundation reviewed the work and independently verified key figures before publication, but errors may remain. If you spot an error, we welcome corrections through our error-reporting page.