Quality objectives
Specific quality objectives of the registry
Currently, none of the registrys quality indicators have status as national quality indicators. The Cancer Registry and the Gynecological Cancer Registry`s professional council collaborate with the Norwegian Directorate of Health to give a selection of the professional environment's quality indicators national status.
The quality indicators are largely based on national and European recommendations/guidelines. The academic council evaluates the indicators every year and adjusts where necessary in accordance with the latest knowledge.
For the first time, this year's report presents quality indicators with target figures. The quality indicators are presented in figure 1.1, which shows a summary at national level.
Quality indicators for pancreatic cancer:
Quality indicators with target figures. From fig. 1.1 i Annual report for Pancreatic cancer 2023
The figure shows which quality indicators have been selected by the specialist group. The colored circles mark the degree of target achievement in 2023.
Results in the report show that the proportion of patients who received chemotherapy less than 4 weeks before death is 15% nationally. This is a number that you want to keep low and which is now defined as a quality indicator in the quality registry.
This year, as last year, we have included detailed data on drug cancer treatment. Such data is included in several analyzes and provides information on the type of chemotherapy given and at what time.
Quality improvements
This is the first year in which the quality registry identifies areas for improvement. We have selected some areas based on results in the report. The areas are described in the points below, with suggestions for further follow-up. The quality registry will follow up measures.
Identified areas for improvement:
• Several hospitals have a higher proportion of patients receiving the last dose of drug cancer treatment within 4 weeks before death. We will contact the hospitals and ask them to go through the records of those concerned
the patients and assess whether the data is correct, and if so whether it is appropriate to change clinical practice.
• It turns out that a large proportion of these patients receive combination treatment. This treatment is associated with high toxicity and should be reserved for patients with ECOG status 1 or better. An action may be that the hospitals go through their patients and the choice of treatment. In this way, it can be assessed whether other choices could have been made.
• The proportion of patients who have a verified diagnosis before starting palliative chemotherapy is gratifyingly high.
The proportion of patients with only a cytological sample turns out to be the highest in the Nordic Health Trust. A dialogue was established with the pathology department at the University of Northern Norway and quality assurance of pathology data has been carried out. It turns out that cytology with a cell block is used more often in the Nordic Health Trust than in other regions. According to the action program for pancreatic cancer, the aim should be for the proportion of biopsy to increase in favor of cytology.