Opportunities for Improvement
Recommendation
Sweden needs an updated National Cancer Control Plan.
Rationale
Indicator 1: Following the publication of the National Cancer Control Plan in 2009, regional cancer centres were established.
While funding is provided by the Swedish government, the government is not responsible for healthcare. Rather, there is a
decentralised approach, and county councils are responsible for the delivery of care. This leads to a competition among the
regions, yet workshop participants felt that regions need to instead collaborate with each other. While regional cancer centres
have their own plans, a national approach—via a national cancer control plan—may help to ensure that everyone has access to
similar standards of care and that economically deprived areas are not disadvantaged. Participants suggested that the plan needs
to address regional referral lead time variation from primary to specialised care.Recommendation
Participation in lung cancer screening trials or studies may enable Sweden to determine whether screening is appropriate for its
population.
Rationale
Indicator 6: There is no evidence to show that Sweden has participated in a lung cancer screening study or clinical trial. However,
workshop participants did not believe it is necessary to conduct a screening trial or study in Sweden. They advocated that
screening programmes should be implemented because early detection of lung cancer can improve outcomes.Recommendation
Decreasing the time between EMA approval and reimbursement of new treatments may help Sweden introduce innovations in
care more effectively.
Rationale
Indicator 13: Workshop participants cited the gap between EMA approval and reimbursement in Sweden. Access to clinical
studies and compassionate use can help to alleviate some of the pressure in the short term (only available in Sweden if the
product is not available for another indication). Longer term it is important to ensure that medications are available—in a
financially sustainable manner—as soon as possible after they have been approved. Failing to do so can create a two-tiered
system whereby only those who can afford to pay for the medication obtain access.Recommendation
Cancer registries lack clinical data. In Sweden, a clinical cancer registry could provide helpful data.
Rationale
Indicator 16: Sweden’s cancer registry has been evaluated as being high quality on a national basis and the complete vital
registration component has been evaluated as being medium quality. Clinicians may find that a detailed, clinical cancer registry
could help to improve the overall care that lung cancer patients receive; it may also help ensure equity between regions.Opportunity 1
Opportunity 2
Opportunity 3
Opportunity 4