Based on the fact that waiting times for cancer patients were unacceptable and the survival rates for cancer poor in Denmark compared to other Nordic countries, a political initiative for improvement was taken. In October 2007 an agreement between the Danish Government and the Danish Regions on acute action and accurate information for all cancer patients was reached. The core of this political decision was to develop integrated cancer pathways as organizational and clinical standards for the diagnostics and treatment for all cancer types.

What is a national integrated cancer pathway?
National integrated cancer pathways focus on “the journey of the patient through the health care system” in order to create better pathways for cancer patients. The aim of the pathways is to reduce processing-times, in particular to reduce referral time, obtain faster diagnosing and quick onset of treatment.  Furthermore it is the objective to ensure that all cancer patients are treated according to national clinical guidelines. All together the national integrated cancer pathways increase the quality of treatment and hereby the cancer survival rates. The design of pathways is described below.

Development of integrated cancer pathways
14 working groups supervised by the National Board of Health were established, each including representatives from the specific medical specialities, the 5 regions, general practitioners, the Nursing Society and, when relevant, pathologists, radiologists etc.. Founded on national evidence based clinical guidelines, cancer pathways are developed as organizational standards for the diagnostics and treatment of 34 cancer types. The cancer pathways are all based on one common template comprising manual-like clinical descriptions that reflect the national guidelines and include time-standards for all steps in clinical processing, flow-chart and organizational schedule. By January 2009 these integrated cancer pathways were implemented in the Danish health care system.

Monitoring of integrated cancer pathways
As an integrated part of the development of cancer pathways, a national solution for monitoring the cancer pathways is developed focusing on time-standards. The monitoring solution is based on the national hospital patient registry.

The effect of the steps taken to improve the cancer care service is now awaited.