New national strategy: Norway to become world-class in cancer

The new ten-year strategy was presented at St Olav’s Hospital in Trondheim by the Norwegian Minister of Health and Care Services Jan Christian Vestre last Friday.

"We are not only launching ambitious national goals but also laying the foundation for ten-year goals. The strategy includes multiple measures and offensive actions that will make Norway word-leading in cancer," announced Vestre.

The strategy includes five national goals to achieve the Minister’s grand vision:

1. To become a pioneering country in cancer prevention
2. To become a pioneering country for good patient pathways
3. To implement user-oriented cancer care
4. To ensure more patients survive and live longer
5. To give the best possible quality of life

An international backdrop

The strategy has been inspired by large EU initiatives, as well as national efforts in the UK and the USA. The Ministry of Health and Care Services has "translated" these international plans to the Norwegian setting.

For cancer prevention, Minister Vestre mentioned: a nicotine and tobacco-free generation, to eliminate cervical cancer and HPV-related cancers, to implement screening programmes against lung and prostate cancer, to diagnose at an earlier stage and to reduce work-related cancers.

For better patient pathways, Vestre mentioned Comprehensive Cancer Centres:

"All patients, no matter where they live, should have equal access to the collected competencies of the region and to a Comprehensive Cancer Centre or Cancer Centre."

The Minister also highlighted the high Norwegian participation in international research projects:

"Our goal is that more people will survive and live longer with and after cancer. Norway will be one of the countries in the world with the highest five-year survival and the research will be world-class. The high participation in EU’s Mission on Cancer calls in 2024 shows that every fourth application with Norwegian participation was granted."

More clinical studies

One of Oslo Cancer Cluster’s main inputs to the national strategy was to make clinical studies an integrated part of cancer treatment.

"We want to double the number of cancer patients that participate in clinical studies. This is how we move the field forward. Through participation, patients get the opportunity to receive cutting-edge treatments, and it contributes to the development of new knowledge that will save lives in the future," stated Minister Vestre.

"We welcome the Minister’s ambitious plans and urge the government to ensure access to clinical trials early in the cancer care pathway. Today, the option to participate in clinical trials is often given to patients as a last option, when they have tried all other standard treatments and are too ill for further treatment," commented Ketil Widerberg, general manager of Oslo Cancer Cluster.

Strengthening collaboration

Minister Vestre underlined that industry is an essential partner when turning the strategy into reality:

"To achieve these goals, there needs to be close collaboration with industry. We cheer for more public-private collaboration – this is how we make ground-breaking innovation happen."

Along with industry collaboration, the Ministry has established a strategic partnership with the Norwegian Cancer Society to follow up the implementation of the strategy.

The Norwegian Cancer Mission Hub, where Oslo Cancer Cluster is a central partner, will be involved throughout these processes.

"For many years, we have highlighted the importance of involving industry to improve Norwegian cancer care. We have showed how this is possible through initiatives like CONNECT, a consortium to drive the implementation of cancer precision medicine, and through the Norwegian Cancer Mission Hub. We are prepared to expand these established channels to achieve the strategy’s ambitious goals," commented Widerberg.

"We are also happy to see that the strategy promises the establishment of a health catapult in ten-year goal number 13. The national health clusters have already an active collaboration through Health Catalyst, where we can deliver this national arena," added Widerberg.

Genetic testing, but no biobanks

Oslo Cancer Cluster has also suggested including genetic tests to improve the precision of cancer diagnostics and the choice of best treatment for each patient. This has been incorporated in ten-year-goal number 12 in the strategy: "All cancer patients will, when relevant for the choice of treatment, be offered a genetic test as part of the development to contribute to make Norway leading in precision medicine."

"This is essential to making personalised medicine a reality for all cancer patients in Norway, but the strategy does not state when or to whom this test will be offered. We urge the Ministry to implement it early in the cancer pathway, so all patients can gain access to innovative treatments for their specific cancer indication," commented Widerberg.

As part of the infrastructure for genetic testing, biobanks are needed to store and systematise samples of blood and tissue, but the word “biobank” is mentioned nowhere in the strategy.

"Biobanks need space and infrastructure, and it is costly to run them. The hospitals often don’t have the means to operate them. We ask how the government plans to set up the necessary infrastructure to support genetic testing? We wish to contribute at the Radium Hospital Campus with a centralised biobank in the next expansion phase of Oslo Cancer Cluster Innovation Park," says Widerberg.

Better use of health data through AI

In our input, we also asked to make health data more accessible for research and development of new treatments. The ten-year goal number 14 mentions that the government will "facilitate simpler, quicker and safer use of data for treatment, research and quality improvement, as well as statistics and analysis".

"We applaud the government’s ambition to make better use of health data in Norway and to strengthen collaboration with Europe in this field, but we think collaboration with industry should be more heavily weighted. Health data is key to develop better cancer treatments – and to run clinical trials smarter," says Widerberg.

Lastly, the strategy mentions artificial intelligence several times as key to revolutionising cancer prevention, diagnosis and treatment, but does not expand on how to implement this in practice.

"In Norway, we have something as unique as the life stories of every citizen, which we can track through personal identification numbers, across various health registries from birth to death, along with detailed medical histories if one develops cancer. We have health data that can reveal who is at risk of developing cancer, which treatments work, and how we can reduce unnecessary side effects or long-term health issues. This is data the rest of the world can only dream of."

"We have gathered several partners in the project NEXTMAP, which demonstrates how data and expertise should be combined and unified to achieve better cancer treatment and prevention. We have applied to the Norwegian Research Council to fund this AI centre and stand ready to make Norway a pioneer in this field," finished Widerberg.

Read more:

1. The national strategy can be read here (in Norwegian): Felles innsats mot kreft – nasjonal kreftstrategi
2. Our input to the strategy (dated October 2023) can be found here (in Norwegian): Oslo Cancer Cluster – Høringsinnspill til nasjonal kreftstrategi