Introduction Variations in access to palliative care (PC) in pancreatic cancer is poorly understood. We aimed to understand the health status of pancreatic cancer patients when presenting to PC.

Methods PC users diagnosed with pancreatic cancer in Victoria, Australia between 2014–2020 were identified through the Palliative Care Outcomes Collaboration. Univariable ordinal logistic regression explored the impact of patient demographics on symptom-related and caregiver distress at presentation.

Results 3899 PC users were identified. Non-English speaking patients were 1.3 times (97.5%CI: 1.1–1.5) more likely than English speaking patients to present at deteriorating state. Females were 1.13 times more likely than males to present with greater fatigue (97.5%CI: 1.02–1.28). No significant associations were observed for patient-rated pain or appetite distress. Caregiver’s of non-English speaking patients were 1.24 times more likely (97.5%CI: 1.05–1.46) to present with higher distress than their counterparts.

Conclusion Non-English speaking patients present to PC at a deteriorating stage. Targeted, culturally-sensitive initiatives to improve early access to PC may be of benefit.