Felles Innsats Mot Kreft — Nasjonal Kreftstrategi 2025–2035

Objectives

Felles innsats mot kreft 2025–2035 is Norway’s ten-year national cancer strategy, guiding public administration, health and care services and other sectors towards lower cancer incidence, improved survival and longevity, and better quality of life for people with cancer and their relatives.[1]It seeks to sustain high-quality publicly provided cancer services amid rising incidence and population ageing.[2][3]

• Make Norway a leading country in cancer prevention and early detection, effective patient pathways, user-oriented cancer care, longer survival and life after cancer, and quality of life for patients and relatives.[4][5]
• Prevent cancer by reducing tobacco and nicotine use, harmful alcohol consumption, unhealthy diet, physical inactivity, overweight, ultraviolet exposure, radon and other harmful environmental or occupational exposures.[6][7][8][9]
• Eliminate cervical cancer and other human papillomavirus-related cancers through high vaccination coverage, accessible testing, follow-up and strong participation in cervical screening.[10][11]
• Improve screening and earlier diagnosis through personalised, evidence-based programmes, initially including consideration of lung and prostate cancer screening, while reducing inequalities in access and participation.[11][12][13]
• Ensure equitable access, regardless of residence or sex, to a Comprehensive Cancer Centre, Cancer Centre or coordinated network, spanning prevention, diagnosis, treatment, rehabilitation, survivorship and palliative care.[14][15][16]
• Provide timely, personalised diagnosis, treatment and follow-up, including relevant genetic testing, precision medicine, prehabilitation, nutritional support, proton therapy and prevention of late effects.[17][18][19]
• Expand patient-centred home pathways, shared decision-making, digital access and needs-led follow-up, while retaining physical appointments where clinically necessary.[16][20][21][22]
• Strengthen research, innovation and clinical studies, including a target to double cancer-patient participation in clinical studies to approximately 15%, with equitable opportunities across population groups and locations.[23][24][25]
• Integrate physical, psychological, social, psychosocial and palliative support throughout cancer pathways, support relatives including children, and enable people who wish to combine treatment with work or education.[26][27][28]

Implementation

Delivery relies on coordinated action by government, regional and municipal health services, patients and relatives, voluntary organisations, researchers, industry and employers.[29][3]The Norwegian Directorate of Health has operational responsibility under the Ministry of Health and Care Services, and coordinates follow-up through the Partnership against Cancer.[4]

• Use the Partnership against Cancer, led by the Norwegian Directorate of Health and including the Norwegian Cancer Society, the Norwegian Association of Local and Regional Authorities, regional health authorities, patient organisations and the Cancer Registry of Norway, to coordinate implementation.[4]
• Hold annual strategic-partnership meetings between the Ministry of Health and Care Services and the Norwegian Cancer Society, focusing on one strategic target area, setting priorities for the following year and adjusting implementation where barriers arise or targets are achieved early.[4]
• Engage the Cancer Mission Hub before and after strategic-partnership meetings to connect authorities, health and care services, businesses, researchers and other stakeholders with national, regional, local and European Union initiatives.[30][4]
• Implement prevention through population policies, regulation, information, incentives, smoking-cessation support, healthy-lifestyle services and systematic workplace health, safety and environmental measures.[6][7][31][9]
• Maintain vaccination and screening programmes, introduce low-threshold human papillomavirus home testing, adapt screening communication to language, culture, health literacy and preferences, and reduce financial and cultural barriers to participation.[10][11][12]
• Require proposals for new national screening programmes to assess research evidence, costs, effects and ethical, legal, organisational, professional and workforce consequences; have the Directorate assess proposals with stakeholders and the Ministry process them through annual budget procedures.[13]
• Coordinate hospitals, general practitioners and municipal services through standardised cancer pathways, effective logistics and communication, with complex surgery, radiotherapy and highly complex medicines-based treatment concentrated at larger hospitals where appropriate.[9][14][15]
• Deliver home pathways through needs-assessment conversations in specialist and municipal services, communicate identified needs between providers and assign follow-up responsibility, normally involving general practitioners or qualified municipal personnel.[32][20]
• Use Helsenorge.no and the Helsenorge app for pathway information, records, medicines and digital dialogue, while expanding digital home follow-up through symptom questionnaires, measurements and welfare-technology solutions, with non-digital alternatives preserved.[21][33][22]
• Strengthen workforce capacity through recruitment, task-sharing, skills development and improved working conditions, particularly across pathology, radiology, surgery, radiotherapy, medicines-based treatment and municipal services.[3][30]
• Develop a health-focused Norwegian Catapult centre and use research, registry and health-data infrastructure to accelerate testing, piloting, innovation, research, quality improvement and clinical-study participation.[23][24][25]
• Monitor implementation through annual strategic reviews, quality registries, pathway activity and quality data, screening follow-up, stage distribution at diagnosis, and regional statistics on completed needs assessments.[4][12][8][14][32]

Monitoring & Evaluation

The strategy combines ten-year goals with annual implementation review, service-quality monitoring, registry-based evidence and targeted outcome measures. Operational follow-up sits with the Norwegian Directorate of Health under the Ministry of Health and Care Services, while the Partnership against Cancer provides cross-sector coordination.[4]

• Review progress through annual strategic-partnership meetings, each focused on one selected target area, agree objectives for the following year, and adjust delivery when barriers threaten ten-year goals or targets are met early.[4]
• Track prevention targets, including a 15% reduction in physical inactivity by 2030, a 20% reduction in harmful alcohol use by 2030, reduced daily tobacco use to below 5% in every age and education group, and a 25% reduction in ultraviolet-related skin cancers by 2040 compared with 2018.[6][7][31]
• Monitor HPV vaccination and screening participation, including whether low-threshold home testing reaches people who seldom attend cervical screening and contributes to fewer cervical cancer cases over time.[11]Continuously follow the cervical, breast and bowel screening programmes and apply quality-improvement measures where required.[12]
• Assess proposed screening programmes against evidence on effects, harms and cost-effectiveness, while requiring proposals for new national programmes to address research, costs, ethical, legal, organisational, professional and workforce implications.[12][13]
• Follow the stage distribution of newly diagnosed cancers continuously and intervene where distribution is unfavourable nationally or regionally.[8]Regularly update cancer pathways to reflect clinical and technological developments and ensure that justified referrals receive assessment and treatment in accordance with them.[34][8]
• Use activity and quality data, with greater use of national cancer quality registries, to follow patient-pathway quality across all service levels.[14]Update national cancer action programmes in response to new knowledge and decisions made through the New Methods system.[14]
• Monitor the number of patients in each health region who complete a specialist-service needs assessment for home cancer pathways.[32]Recognise that completed conversations should increase over time but that some patients neither want nor need such a conversation.[32]
• Use patient-generated information, shared-decision-making tools, electronic symptom questionnaires and patient-reported measurements to adapt services, with nurses and doctors reviewing responses when needed.[21][33][22]
• Monitor digital-service uptake, including the finding that almost 86% of general practitioners used Helsenorge digital dialogue in 2024 and that municipal digital dialogue services covered approximately half the population.[21]
• Follow treatment benefit, adverse effects and loss of benefit for people receiving treatment for incurable cancer, supporting avoidance of unnecessary treatment.[17][18]
• Measure progress towards doubling cancer-patient participation in clinical studies, with an indicative target of about 15%, while recognising variation by cancer type.[25]Use Cancer Watch and the European Cancer Information System to improve the quality, harmonisation, completeness and timeliness of registry statistics.[24]

Available baseline evidence includes five-year relative survival in 2019–2023 of 77.6% for men and 77.4% for women.[35]The strategy also reports more than 38,000 new cancer cases annually, projected to rise to around 45,000 annually within ten years and more than 50,000 by 2040.[3]Several sections do not specify a consolidated indicator framework, reporting cycle, evaluation methodology, public reporting requirements or formal accountability process beyond the arrangements described.[30][20][22][25]

Costing & Financing

Implementation is expected to operate within the economic frameworks, workforce availability and other conditions of responsible authorities and health and care services.[30]The strategy identifies major resource pressures from rising cancer incidence, population ageing, workforce shortages and diagnostic bottlenecks, but does not provide an overall implementation budget, financing plan, quantified funding gap or economic assumptions.[2][3][15]

• Require new national screening proposals to include analysis of costs and effects, with the Ministry of Health and Care Services considering proposals through annual budget procedures.[13]
• Mobilise non-monetary resource mechanisms through the Norwegian Catapult scheme, research and innovation funding opportunities, health-data infrastructure and long-term support for clinical studies.[23][24][25]
• Expand capacity in pathology, radiology, surgery, radiotherapy, medicines-based treatment and municipal services to meet future demand.[3]Prioritise workforce deployment, digital tools and artificial intelligence as precision diagnostics, personalised treatment and clinical research increase demand on radiology and pathology.[15]
• Develop capacity for cancer centres, home pathways and digital follow-up, although no budgets, unit costs, allocations or funding sources are specified for these measures.[16][32][20]
• Recognise that needs-led digital outpatient follow-up may release service capacity, save staff time, improve quality and support more even workloads, without assigning a monetary value to these effects.[22]
• Provide free smoking-cessation medicines and guidance in the Vestre Viken pilot, while noting that neither its cost nor a national funding allocation is specified.[10]
• Expand the clinical dietitian model development programme to the municipal health and care service from 2025 and introduce proton therapy in Oslo and Bergen in 2025, without associated monetary values.[17][18]

Prevention and screening are framed partly in economic terms: screening should be safe, modern and cost-effective, but no programme budgets or financing mechanisms are specified.[12]Approximately 13,000 cancer cases, more than one in three, could be prevented annually, but this is an epidemiological estimate rather than a financial saving.[36]