Cancer care in Denmark

Abstract

Denmark is a small country with a little more than 5 million inhabitants. Placed in Scandinavia and considered being a rich and affluent society, Denmark has the honour of having a high-quality health-care system delivering quality treatment and care for all groups of patients. According to international standards and costs, it is a highly efficient system. Health care and hospitals in Denmark are funded by taxes paid by the citizens. All citizens are guaranteed access to medical assistance without having a private insurance. That means that most medical treatments and care are freeFno one has to calculate the expenses before attending a physician or a hospital. The health care services in Denmark are the responsibility of 14 counties and the main capitol area. Cancer patients are admitted into both surgical and medical departments all over the country, but the specialised oncological and radio therapeutic treatment is placed in 5–6 special departments geographically spread all over the country, which means that most of the cancer patients are admitted to general surgical and medical departmentsFonly those requiring specialised treatment reach the specialised wards. Every year about 25,000 Danes are diagnosed with cancer. The number is increasing and it is assumed that about 200,000 Danes are living with cancer or side effects of a cancer disease. The most common cancers in Denmark are breast cancer, colon cancer, lung cancer, skin cancer and cancer of the prostate. Furthermore, Denmark has the highest incidence of cancer and the lowest overall 5year survival among all the Scandinavian countries (National Cancer Strategy, 2002; Cancer Statistics 1998–2002, 2003). Also, in 1999 cancer became the most frequent cause of deaths in Denmark overtaking heart diseasesFthe most common cause of death in most other western countries (National Cancer Strategy, 2002; Cancer Statistics 1998– 2002, 2003; Cancer Report, 2003). Therefore, the Danish Ministry of Health and the National Board of Health in 1998 appointed a group of experts to develop a National Cancer Strategy. The group analysed current practice to identify possible reasons for this trend and to point out areas for improvement. The analysis showed that the number of cases will increase in the future. Prevention and health campaigns have not been a successFDanes and especially Danish women smoke more than their counterparts in the rest of Scandinavia, and cancer patients do not change their lifestyle after diagnosis (National Cancer Strategy, 2002). The group pointed out that there are general differences of lifestyle in the Scandinavian countries. Smoking, high caloric diet and a higher consumption of alcohol are contributing factors to the higher cancer incidence in Denmark (National Cancer Strategy, 2002). Patients with some cancer diseases have poorer survival rate than patients with the same kind of disease in other countries, especially compared to Sweden (National Cancer Strategy, 2002). There may be a delay in diagnosis and treatment, while the general practitioners are more reluctant to refer the patient for further examinations as well as lack of capacity to carry out the examinations and start treatment quickly. Based on their assessment the expert group identified the following needs in their report (National Cancer Strategy, 2002):