Cancer Care Epidemiology

The main objective of this project has been to examine several aspects of cancer care in Norway. Firstly, the utilization, access, and treatment outcome after radiotherapy were addressed. The results showed geographical variation in the utilization rates for radiotherapy, and factors such as high age, low socioeconomic status, and longer travel distance were associated with reduced odds of receiving radiotherapy.

Secondly, the project addressed survival inequalities in common cancer in Norway. The results showed regional variations in cancer survival, and these variations persisted after adjustment for important prognostic factors.

Thirdly, in-depth analyses on factors associated with treatment and survival of lung cancer in Norway were conducted. The results from these analyses showed that regional differences in the likelihood of receiving treatment, and patients with low socioeconomic status were less likely to receive any treatment at all. The results also showed regional differences in cancer survival.

Fourthly, the inclusion, processes, and outcomes during the implementation of cancer patient pathways in Norway were examined in common cancers. The results show reduced waiting times to treatment, inequalities in emergency presentation prior to a cancer diagnosis, and inequalities in inclusion to cancer patient pathways and treatment.

Finally, the project has examined the access to new cancer drugs and provided real-world evidence for treatment of patients diagnosed with advanced cancer (prostate, lung, breast, and skin) in Norway. The initial results indicated that only around half of metastatic prostate cancer patients receive systemic treatment. Moreover, for patients with advanced lung cancer, it was shown that survival improved after the introduction of immunotherapy in Norway, but it is not as good as results in clinical trials.

Link to published articles:

Utilization of radiation therapy in Norway

Factors influencing access to palliative radiotherapy

Preoperative chemoradiotherapy for rectal cancer and impact on outcomes

Regional variations in cancer survival

Lung cancer treatment is influence by income, education, age and place of residence