Program Wieloletni Pn. Narodowa Strategia Onkologiczna Na Lata 2020-2030

Objectives

The National Oncology Strategy for 2020–2030 is Poland’s integrated framework for reducing cancer incidence and mortality, improving five-year survival towards European levels, and ensuring patient-centred, high-quality and comprehensive care across prevention, diagnosis, treatment and survivorship.[1][2][3]It responds to high cancer mortality, survival gaps and regional inequalities in access and outcomes.[4][5][6]

• Reduce cancer risk through health education, healthy-lifestyle promotion, tobacco control, healthier diets, physical activity, reduced alcohol consumption, protection from ultraviolet radiation, and vaccination against hepatitis B and human papillomavirus.[7][8][9]
• Strengthen primary and secondary prevention by increasing awareness and uptake of organised screening for breast, cervical and colorectal cancers, while extending screening and risk-based preventive care for hereditary, lung, prostate, skin, head and neck, and liver cancers.[10][11][12][13]
• Improve earlier diagnosis, coordinated treatment and quality of care by reducing fragmentation, standardising diagnostic and therapeutic pathways, expanding access to modern medicines, and developing comprehensive care throughout the patient pathway.[5][14][15]
• Develop workforce capacity through improved undergraduate and postgraduate education, full use of oncology-speciality training places, and a 10% increase in doctors with oncology or related specialities by the end of 2028.[16][17][18]
• Advance research, innovation and personalised oncology by increasing participation in clinical trials, supporting non-commercial and early-phase research, strengthening biobanking and research infrastructure, and improving access to effective diagnostic and therapeutic technologies.[19][20][21][22]
• Establish comprehensive coordinated oncology care through the National Oncology Network, Cancer Units, competence centres, quality standards, accredited pathology and genetic diagnostics, and access to rehabilitation, palliative, hospice, psychological and social support.[15][23][24][25][26]
• Achieve measurable improvements in screening participation, mortality, survival, workforce capacity, clinical-research access and quality of life, including targets for breast, colorectal and cervical screening and selected cancer mortality rates.[27][28][22]

Implementation

Implementation combines annual action schedules, public financing, cross-sectoral delivery, service reform, regulatory measures, workforce investment, data systems and quality assurance.[3][29][30]The Minister of Health coordinates the Strategy, approves annual schedules following adoption of the State Budget Act, monitors delivery and submits an annual report to the Sejm of the Republic of Poland.[31][29][30]

• Organise delivery through the Ministry of Health and its subordinate or supervised bodies, the National Health Fund, the Medical Research Agency, the Ministry of Science and Higher Education, healthcare providers and other designated or competitively selected implementers.[30][6]
• Use annual schedules to allocate funding across action areas, define delivery methods and scope, and determine whether investment purchases are undertaken by individual implementers or through joint procurement.[30]
• Implement the National Oncology Network as a hierarchy of specialised treatment centres, with Provincial Coordinating Centres coordinating regional care and Cancer Units introduced for major adult, childhood and rare cancers.[23][24]
• Standardise care through evidence-based diagnostic, therapeutic and organisational guidelines; use information tools and trained staff to verify compliance; and introduce mandatory accreditation for publicly funded oncology pathology from 2022 and genetic diagnostics by 2026.[24][32]
• Engage primary care, occupational health, schools, local authorities, non-governmental organisations, patient organisations and social campaigns in prevention, health education and screening promotion.[33][34][35]
• Improve screening delivery through active invitations, pilots, digital and electronic communication, Public Health Centres, human papillomavirus DNA testing, faecal immunochemical testing and strengthened quality controls for mammography, cytology, colonoscopy and professional certification.[28][36][13][37]
• Build workforce supply through expanded medical education, revised curricula and examinations, priority-speciality remuneration, residency places, specialist-training support and multi-year workforce planning based on demographic and epidemiological forecasts.[38][17][18][39]
• Support research through clinical-trial legislation, Clinical Research Centres, the Clinical Trials Academy, data repositories, biobanking arrangements, standardised data-sharing systems and Medical Research Agency financing of innovative studies.[40][41][20][42]
• Strengthen monitoring through the National Cancer Registry, organ-specific and screening registries, medical-register analysis, the National Oncology Portal and data on treatment effectiveness and quality by cancer type and provider.[2][43][26][44]
• Require implementing entities to submit annual reports to the Minister of Health by 31 March of the following year, followed by submission of the ministerial annual implementation report to the Sejm by 31 May.[29]
• Finance the Strategy from public funds, including capped State Budget allocations of 250 million Polish zloty in 2020, 450 million Polish zloty annually in 2021–2023, and 500 million Polish zloty annually in 2024–2030; non-public funding may be used where provided for in implementation schedules.[29][45]

Monitoring & Evaluation

The National Oncology Strategy combines outcome targets, service-quality controls, cancer-registration data and formal annual reporting. Its principal monitoring focus is earlier detection, reduced mortality, improved five-year survival, equitable access and the quality of coordinated care.[46][2][23][44]

• Track epidemiological trends through the National Cancer Registry, organ-specific registries, screening registries and dedicated databases, covering cancer incidence, mortality, survival, stage at diagnosis, care status and procedural quality.[4][47][48][44]
• Measure screening participation and quality, including targets for breast screening of 60% by 2024 and 75% by 2027, colorectal screening of 30% by 2024 and 45% by 2027, and cervical screening of 60% by 2024 and 80% by 2027.[28]
• Assess progress against cancer-specific mortality targets for 2025, using 2017 observed values and age-period-cohort projections as comparison points.[27]
• Monitor workforce performance through full occupation of oncology-speciality training places by the end of 2024 and a 10% increase in doctors with oncology or related specialities by the end of 2028.[17]
• Apply quality assurance through pathology and genetic-diagnostic accreditation, compliance controls for diagnostic and therapeutic standards, strengthened mammography and cytology quality controls, and certification of colposcopists and cytodiagnosticians.[13][37][24][32]
• Evaluate the pilot of the 1+ oncology network as evidence for the National Oncology Network, and use the Network to provide information on service availability, location, effectiveness and quality by cancer type and provider.[49][23]
• Monitor innovation through data collection and analysis on the effectiveness of innovative therapies, clinical-trial participation, non-commercial trial activity, early-phase trial capacity and access to funded oncology therapies.[50][22][51]
• Require implementing entities to submit annual reports to the Minister of Health by 31 March of the following calendar year; require the Minister to submit the preceding year’s implementation report to the Sejm by 31 May.[29]
• Update the Strategy at least every five years when significant developments in oncology, health actions or policies warrant revision.[31]

Costing & Financing

The Strategy is primarily financed from public funds, supplemented where implementation schedules permit by non-public sources. State-Budget allocations are capped at 250 million zlotys in 2020, 450 million zlotys annually in 2021-2023, and 500 million zlotys annually in 2024-2030.[29][45]

• Use health-financing growth associated with the so-called 6 percent law, which guarantees health-financing resources of at least 6% of gross domestic product in 2024, as the expected basis for fully financing implementation.[45]
• Permit additional Strategy financing from savings within the health-ministry budget section, subject to Finance Minister approval, for critical, underfunded or new strategic areas.[45]
• Allocate resources through annual action schedules approved after adoption of the State Budget Act, specifying funding distribution, delivery methods and the scope of activities.[30]
• Draw on State-Budget funds, National Health Fund resources, Medical Research Agency resources, ministry budgets, European Union funds, institutional budgets and, where relevant, non-public funding.[29][30][52]
• Finance breast and cervical screening through the National Health Fund, colorectal screening through the National Cancer Control Programme, and selected prevention pilots through European Union programmes.[10][11][12]
• Transfer public financing for hereditary high-risk family care and colorectal screening to the National Health Fund from 2022, and provide public funding for high-risk lung and prostate screening from 2024.[13]
• Fund infrastructure modernisation and equipment replacement during 2020-2030, including pathology equipment in 2023-2026, genetic-diagnostic equipment in 2024-2026 and interventional-radiology equipment in 2023-2026.[44][31]
• Recognise resource pressures from fragmented care, duplicated services, obsolete equipment, limited radiotherapy capacity, research-institution budget constraints and information-system incompatibility.[14][20][53]