Five thousand eight hundred and eighty one cases of pancreatic cancer and 126 cases of ampullary carcinoma were registered in England and Wales in 1979. Fourty four per cent of men and 59% of women were aged 70 or over at the time of presentation. Sixty six per cent did not undergo a surgical operation. One thousand seven hundred had a bypass operation for relief of jaundice (34%) and 470 underwent gastrojejunostomy for pyloric obstruction (8%). Only 200 pancreatic resections were performed (3%). Ten per cent of all the patients survived for one year and less than 3% for five years. Most of the long term survivors at five years after pancreatic resection had carcinoma of the ampulla of Vater.