Focus area 4. More people will survive and live longer with and after cancer

The Government wants Norway to have one of the world’s highest five-year survival rates following a cancer diagnosis. Norway should have the lowest cancer mortality, and cancer patients will be offered diagnostics, treatment, follow-up and rehabilitation of high international standard through our public health service. At the same time, it is important to avoid overtreatment, which could shorten the lives of cancer patients as well as lower their quality of life.

Early detection of cancer could save lives. We would like to shorten the time from new research documents a measure’s effect until the findings benefit patients, provided that the measure complies with national applicable prioritisation criteria. New and better treatments help to increase cancer survival. The fact that more people survive and live longer with cancer also means that more people live with late effects of cancer treatment. However, new treatment methods could help to reduce the risk of side effects and late effects. Proton therapy will be offered in Oslo and Bergen starting in 2025, and patients from all regions will be guaranteed equitable access to proton treatment.

Ten-year goal 11

All patients will get the right treatment and follow-up at the right time by means of good prehabilitation and good prioritisation

The intention behind this goal is to ensure that the investigation and treatment of diagnosed cancer is provided with a content and at a pace that ensure the best possible outcome and reduce the burden associated with completing the planned course of treatment. New methods that meet the national prioritisation criteria will be made available as soon as possible.

All patients diagnosed with cancer will be assessed and treated in accordance with the timeframe and medical content set out in the relevant patient pathway and, if applicable, national action plan. This rule will only be deviated from when required by individual considerations, for example other medical conditions or complications. In cases where no patient pathway or national action plan applies, an individual plan will be made for each patient based on the same principles.

In case of incurable cancer, clear treatment goals are stipulated before treatment starts. There is also a plan in place for how to identify and follow up the benefits, side effects and, if relevant, subsequent loss of benefit in order to avoid overtreatment with pertaining side effects and strain for both the patient and their next of kin.

Prehabilitation, meaning measures taken before treatment, is considered and included in patient pathways and action plans for each form of cancer to the extent that such inclusion is evidence-based.

Priorities when new treatment methods are introduced will follow the applicable national prioritisation criteria. The process leading up to a decision to introduce a new method should be as swift as possible and should also include relevant suppliers and hold them accountable for ensuring a speedy process. Once the decision to introduce the new method has been made, the service will soon be informed through direct communication and by information about the new method being incorporated into the applicable national action plans. The decision can also be included as an appendix to the action plan to make it available to doctors treating patients as soon as possible on the Norwegian Directorate of Health’s website ( Helsedirektoratet.no ).

Cancer treatment can affect the body’s ability to eat and digest food and absorb nutrients. Many patients need individual follow-up in relation to food and nutrition. Cancer-related malnutrition and unwanted weight gain associated with treatment are preventable. Nutrition experts can help people suffering from cancer to improve their nutritional status.

Figures from the Norwegian Directorate of Health show that fewer than half of Norwegian hospitals have a nutritional strategy for their patients. As part of the work to follow up the cancer strategy, we need to make sure that all hospitals have such a strategy in place. Key guidelines include the national professional guidelines for preventing and treating undernutrition and the upcoming guidelines for food and meals in (healthcare) institutions.

In the course of work on the national strategy God og riktig mat hele livet – Nasjonal strategi for godt kosthold og ernæring hos eldre i sykehjem og som mottar hjemmetjenester (‘Good and appropriate food throughout life – National strategy for good diet and nutrition among elderly in nursing homes and receiving home care service’ – in Norwegian only), a model development programme for clinical nutritionists as a resource in the care services was established in 2020. From 2025, this model development programme will be expanded to cover all of the municipal health and care services. The scheme is intended to contribute to boosting preventive work and strengthening the follow-up of a number of target groups dealing with nutritional challenges in the municipalities.

Ten-year goal 12

If relevant for the choice of treatment, all cancer patients will be offered genetic testing as part of the development towards making Norway a leading country in the field of precision medicine

If relevant to the choice of treatment, it is important that cancer patients undergo good and precise investigation and diagnostic testing to ensure that the treatment administered is optimised and as well adapted to the individual patient as possible. The National Strategy for Personalised Medicine aims to make personalised medicine an integral part of the health service.

Genetic testing and other precision diagnostics will develop during the strategy period in terms of what can be analysed, how extensive the analyses can be and how quickly they can be done, as well as in our ability to interpret complex analysis results. At the same time, new treatment methods will emerge for which precision diagnostics will be crucial to determine when to use and when not to use the new methods. New personalised medicine measures must be considered based on the same prioritisation criteria as other new methods being considered for introduction in the publichealth service.

Patients could need precision diagnostics at any stage. The determination of when precision diagnostics are relevant will be based on whether they will have a bearing on the choice of treatment, including, if relevant, participation in clinical trials. Broader availability of precision diagnostics could make Norway a more attractive country for clinical trials. Offering genetic testing to more patients is one of the flagship initiatives of the EU’s Beating Cancer Plan.

Ten-year goal 13

A health catapult initiative will be established

The Norwegian Catapult programme is a scheme intended to assist the establishment and development of national multi-use centres for testing, piloting, simulation and visualisation. An initiative could contribute to more innovation, more rapid adaptation and improved competitiveness in the health sector.

At these centres, enterprises will be able to test, simulate and visualise technologies, components, products, solutions, services and processes. The Government have high ambitions to establish a catapult initiative in the health sector and wants to strengthen the current catapult services to enable the health industry to benefit more from the scheme. Easy access to expertise, equipment and suitable premises is intended to smooth the way from concept stage to market introduction. There are three product categories in the health area: pharmaceutical production, digital health and medical equipment. The established catapult centres administered by the Industrial Development Corporation of Norway (SIVA) offer expertise, testing and verification in parts of these three product areas.

Ten-year goal 14

Norwegian cancer research will be world-leading

The goal for Norwegian cancer researchers to remain world-leading in some disciplines and succeed in the competition for national as well as international research and innovation funding is an important one. This is because research and innovation of high quality and relevance will provide new knowledge to the services about how to diagnose and treat cancer, and society will gain knowledge about the prevalence of cancer in the population as well as about how to prevent cancer. Researchers based in Norway will engage in broad international research cooperations, thus contributing to the international knowledge bank.

Researchers based in Norway will take an active role in important EU cancer initiatives including the EU’s Beating Cancer Plan and Cancer Mission. Cooperation with scientists from other countries could provide valuable insights that can help to optimise treatment of cancer patients across national borders and continents. Active participation by researchers from Norway at conferences and as international experts could form the basis for further cooperation with the health industry on clinical trials.

Norway’s good health data puts the country at a considerable advantage in research, innovation and business development. The Government intends to facilitate easier, quicker and more secure use of data for treatment, research and quality improvement as well as for statistics and analyses. Bringing the Cancer Registry of Norway and the other national health registers together under the Norwegian Institute of Public Health is intended to help to strengthen this work. High-quality cancer statistics from population-based cancer registries in Europe will be crucial to achieving the goals set out in the EU’s Beating Cancer Plan. The Cancer Registry of Norway at the Norwegian Institute of Public Health has been given the crucial role of leading the work to strengthen European cancer registries through the government collaboration Cancer Watch. This work will help to improve the overall quality of European cancer registries, harmonise data and make them more complete. At the same time, Cancer Watch will ensure that quality-assured statistics are made available more quickly on the European Cancer Information System platform.

Ten-year goal 15

The number of cancer patients taking part in clinical trials will be doubled

It is a goal to double the number of cancer patients included in clinical trials. A rough estimate indicates that this will make up about 15 percent, but the number of patients who take part in clinical trials will vary depending on which form of cancer they have. Participation in clinical trials gives patients the chance to test new treatments and help to develop new knowledge. The opportunity to engage in research and professional development is a source of motivation for healthcare professionals.

The Government has an ambition for clinical research to become an integral part of all patient treatment and clinical practice in a long-term perspective. The Government wants to continue the long-term focus on clinical trials and will develop the National action plan for clinical trials further in 2025.

For patients who may benefit, inclusion in clinical trials should be considered early in the course of their treatment. However, participation in clinical trials will be relevant in all phases of cancer. It is a goal to achieve the most equitable access possible to participation in clinical trials regardless of patients’ type of cancer, age, sex, ethnicity and geography, see ten-year goal number 5 (on CCCs and CCs).