We need a new cancer strategy
Our welfare state provides universal access to knowledge, healthcare and assistance in different circumstances in life. Good health services should be available to everyone in Norway when needed, and this includes cancer care. That is why it is important that we have a strong public health service of high quality that is accessible and have the shortest possible waiting times. This health service must be good enough to be the first choice both for patients and for healthcare professionals.
Three in four newly diagnosed cancer patients are women and men over 60 years of age. We need to be prepared for the increase in cancer cases that the aging population will bring. This will require an increase in capacity in the fields of pathology, radiology, surgery, radiotherapy and pharmaceutical treatment, among others. The growing number of cancer cases and the age composition of the population will also require more capacity and expertise to be developed in the hospitals as well as in municipal health and care services. This will require good cooperation and coordination between the different health service levels, the higher education sector, the healthcare industry and the voluntary sector to address patients’ needs and provide predictability and a sense of security for patients and next of kin.
The increasing number of cancer cases is among the most important public health challenges facing us. This is a challenge we share with the EU countries. In 2023, more than 327,000 persons living in Norway had cancer or had previously had cancer. This represents an increase of more than 100,000 people over a ten-year period. More than 38,000 new cancer cases are diagnosed each year, and about 40 percent of us will have been diagnosed with cancer at least once by our eightieth birthday. The number of new cancer cases will continue to increase in the years to come. Calculations by the Cancer Registry of Norway shows that in ten years, 45,000 new cases per year will be registered. By 2040, there will be more than 50,000 new cases a year.
As the number of older people living with cancer and the number of older people suffering from dementia increase, there will also be an increasing number of people suffering from both these conditions. The health service will have more difficult assessments to make when it comes to individual adaptation of cancer treatment and how treatment is to be administered. Patient follow-up must be adapted to take account of the fact that dementia impairs the patient’s cognitive understanding and ability to communicate, both regarding pain and other complaints and when it comes to cooperating on diagnosis and treatment.
While more people are diagnosed with cancer, there are also more who make a full recovery, and many cancer patients live longer and enjoy a higher quality of life than cancer patients in the past. This is caused by a combination of earlier diagnosis and an increase in , better and more personalised treatments for different forms of cancer. For some forms of cancer, developments have resulted in the vast majority of patients surviving, and even patients with advanced cancer can have a good prognosis. For other forms of cancer, however, there have been few therapeutic breakthroughs. Pancreatic cancer and liver cancer are examples of cancers that only a small percentage of patients make a full recovery from.
Today, nearly three in four people diagnosed with cancer survive for five years of more. For the period between 2019 and 2023, a total of 77.6 percent of men and 77.4 percent of women were alive five years after having been diagnosed with cancer compared to corresponding population groups of men and women without the same cancer (relative survival). The highest five-year survival rate during the period 2019–2022 was for testicular cancer, at 98.5 percent, followed by prostate cancer at 95.7 percent, melanoma at 95.7 percent for women and 90.3 percent for men, thyroid cancer at 95.1 percent for women and 90.3 percent for men, and 92.5 percent of women with breast cancer were still alive five years after their diagnosis.
The World Health Organization estimates that between 30 and 50 percent of all cancer cases could be prevented by lifestyle changes. National, regional and local authorities, municipal health and care services and the different specialist health services, as well as civil society and business and industry, must all focus their attention and expertise on measures to promote healthy lifestyles in the population. The population must be informed about factors that could reduce the risk of cancer and be motivated to change their habits. The most important single factor is to refrain from using tobacco, as smoking causes the most new cases of cancer. A lifestyle where people protect themselves from sunburn, maintain a normal body weight, engage in sufficient physical activity, have a healthy diet and drink alcohol in moderation can also prevent cancer.