Despite the introduction of numerous reforms and long-standing programs, such as the National Cancer Control Program and the National Oncology Strategy, the Polish oncology care system still fails to provide comprehensive treatment and equal access to services. Staff shortages, dispersion of services and delays in diagnosis and treatment remain a problem. The pilot program of the National Oncology Network, which was supposed to streamline the process of cancer treatment, has so far failed to produce the expected results, the NIK alarms.
Comprehensive oncology care in Poland still only on paper?
Published Feb. 25, 2025 10:56
Cancer is the second most common cause of death in Poland, and the survival rate is lower than in other EU countries. Although the number of cases is increasing, the health care system still does not provide equal and comprehensive oncological treatment. What are the conclusions of the NIK audit?
Main problems of the oncology system
1. unequal access to specialists
In Poland, the number of oncologists and hematologists is extremely uneven from region to region. Some provinces have almost five times as many specialists as others. The Opole province does not employ a single pediatric oncologist or hematologist, which means that the youngest patients have to seek help in other parts of the country.
2. problems with diagnosis and treatment
Oncology diagnostics in Poland is lagging behind schedule, and a significant portion of services are performed after the scheduled dates:
- 25-34% of pre-diagnosis cases exceed the acceptable time frame,
- 24-28% of in-depth diagnostic cases take place after the deadline.
In addition, only 15% of surgical oncology facilities provide patients with comprehensive care, including endoscopy, radiation therapy and outpatient specialty care.
3. failed pilot of the National Cancer Network
A pilot of the National Cancer Network (NSO) has been running since 2019, which was supposed to introduce standardization of services and better monitoring of treatment outcomes. However, after six years and more than PLN 130 million spent, the pilot has failed to provide the key data needed for implementation, forcing the Health Ministry to postpone the full introduction of the KSO until April 2025.
The main problems of the KSO pilot:
- Lack of standardization of the description of pathomorphological studies.
- Failure to develop model treatment pathways for specific cancer types.
- Lack of IT tools, such as the Electronic Card for Cancer Diagnosis and Treatment (e-DiLO).
- Inadequate supervision by the Minister of Health of the KSO implementation process.
4. unequal treatment of patients
In some facilities, as many as 80% of patients receive services outside the oncology package, which means an increase in waiting time for diagnostics by 20-30%. This is a blatant violation of the principle of equal treatment of patients.
5. problems with the cancer database
The proper functioning of the oncology system depends on the efficient transfer of data to the National Cancer Registry (NCR). Unfortunately:
- Only 3% of treatment facilities are integrated with the NCN.
- Only 18 hospitals nationwide have automated data transfer systems.
Without reliable data, it is difficult to make effective decisions on improving the oncology treatment system.
Conclusions and recommendations
What should the Ministry of Health do?
- Standardization of pathomorphological diagnosis - defining the minimum data needed for diagnosis.
- Implement model treatment pathways for the most common cancers.
- Better organization of the information system - mandatory integration of establishments with the NCR.
- Increase participation in screening to improve early detection of cancer.
What can treatment facilities do?
- Better organization of queues and waiting lists.
- Timely diagnosis and treatment of patients.
- Reliable completion of oncology records and reporting to the NSC.
Source: NIK
