Pancreatic Cancer Accredited Program – Needs Assessment Survey

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* 1. Please tell us about your specialty (GP/FM; CCFP; other)

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* 2. When you hear pancreatic cancer, what comes to your mind?

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* 3. Have any of your patients been diagnosed with pancreatic cancer?

Yes

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* 4. In your patients with GI symptoms, how often have you considered pancreatic cancer as the most likely diagnosis/foremost differential diagnosis?

Never

Rarely (less than 10% of the time)

Sometimes (up to half the time)

Frequently (more than half the time)

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* 5. Have any of your patients come to you asking for pancreatic cancer screening and/or surveillance because of a positive family history or genetic predisposition?

Yes

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* 6. Are you familiar with the Eastern Canada Colorectal Cancer Consensus Conference/Western Canadian Gastrointestinal Cancer Consensus Conference (EC5/WC5) and/or American Society of Clinical Oncology (ASCO) guidelines for pancreatic cancer?

Yes, both

EC5/WC5 Canadian guidelines only

ASCO only

None

Other (please specify)

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* 7. How knowledgeable do you feel about the following aspects of pancreatic cancer?

	Very little knowledge	Some knowledge but I feel I need more	Adequate level of knowledge	Advanced level of knowledge
Epidemiology	Epidemiology Very little knowledge	Epidemiology Some knowledge but I feel I need more	Epidemiology Adequate level of knowledge	Epidemiology Advanced level of knowledge
Etiology and risk factors	Etiology and risk factors Very little knowledge	Etiology and risk factors Some knowledge but I feel I need more	Etiology and risk factors Adequate level of knowledge	Etiology and risk factors Advanced level of knowledge
Disease presentation	Disease presentation Very little knowledge	Disease presentation Some knowledge but I feel I need more	Disease presentation Adequate level of knowledge	Disease presentation Advanced level of knowledge
Diagnostic algorithm	Diagnostic algorithm Very little knowledge	Diagnostic algorithm Some knowledge but I feel I need more	Diagnostic algorithm Adequate level of knowledge	Diagnostic algorithm Advanced level of knowledge
Treatment and management	Treatment and management Very little knowledge	Treatment and management Some knowledge but I feel I need more	Treatment and management Adequate level of knowledge	Treatment and management Advanced level of knowledge

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* 8. What specialist(s) should a patient diagnosed with pancreatic cancer be referred to? (Select all that apply)

Surgical oncologist

Medical oncologist

Nutritionist

Geneticist

Psychologist

Radiation oncologist

Gastroenterologist

Other (please specify)

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* 9. Should a patient be referred to pancreatic cancer centers/tertiary care centers/high-volume pancreatic cancer centers?

Yes, to a pancreatic cancer center

Yes, to a tertiary care center

Yes, to a high-volume pancreatic cancer center

No, the patient does not need to be referred to these centers

Other (please specify)

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* 10. Is genetic testing (the assessment of a patient’s DNA or RNA sequence for mutational abnormalities or variants) indicated for a patient diagnosed with pancreatic cancer?

Yes

Unsure

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* 11. What topics in pancreatic cancer would you be particularly interested to learn more about? Please specify:

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* 12. If you would like to be notified when the accredited program is open to participation, please provide your email.

Physician's name