Quality management in (prostate) cancer care: what do European cancer control plans tell us?

Abstract

Introduction and purpose National cancer control plans cf. programmes (NCCPs) are policy instruments to structure, map and organise comprehensive cancer policies in a country or its region. One of their important objectives is improvement of quality in cancer care and control. Methods We explored several methodological papers on NCCPs and analyses on their implementation in the European Union as well as recommendations and guidelines concerning prostate cancer screening and management. Results and discussion Quality is still not a very common feature of NCCPs as an independent, self-standing issue. Only a handful of countries structured and implemented specific activities to monitor quality of cancer care in their policy documents. In others, quantitative approaches focusing on epidemiology and provision of care are dominant, not focusing on indicators, especially those of process and outcome. In view of that and exploring its position in a broader sense, prostate cancer is poorly represented and insufficiently addressed, in particular with respect to screening, but also in after-care and survivorship challenges. Conclusions Given that methodological tools on NCCPs envisage quality as a separate chapter and an overarching topic in NCCPs, the current situation shows that we are still a long way away from the goals set. Absence of structured approaches for a cancer, such as prostate cancer, in NCCPs demonstrates the lack of consistency on all phases of comprehensive control on a frequent cancer, where practices and outcomes show unacceptable variations.