This is how cancer surgery can be promoted in Sweden

One problem, according to Per J. Nelson, chief medical officer at Karolinska University Hospital and lecturer in surgery and lecturer at Karolinska Institutet, is that hospitals perform too few operations to be able to maintain high quality.

According to the government investigation, “Training gives a skill – focused care for the best patient.” (SOU 2015: 98) At least 50-100 operations are required annually in order for the works to be performed with high quality.

in Discussion article in Svenska Dagbladet Per J Nilsson takes rectal surgery as an example of areas where cancer surgery can be improved.

Approximately 2,000 people are diagnosed with rectal cancer each year. Of these, 1200-1500 people are operated on annually. The operations are performed in 30 different hospitals in Sweden. But only six of them perform more than 50 operations a year, according to open data from cancercentrum.se for the period 2017-2021.

In Sweden’s neighboring countries, a different model was chosen. In Finland, five hospitals perform rectal cancer surgery, and Denmark has also chosen to centralize the process.

Per J. Nilsson, who was also president of the European Colon and Rectal Society and the Swedish Society of Colon and Rectal Surgery, co-author of National Care Programs and an expert in the NHV Group for Advanced Pelvic Surgery, wants to see an increased focus of cancer surgery in Sweden as well. It offers three suggestions for actions for a better national cancer surgery strategy.

• Reducing the number of key personnel in Swedish healthcare.
• Use the NHV (National Highly Specialized Care) model with expert groups and binding decisions also at the regional level.
• Further develop and enhance the opportunities of the National Council for Health and Welfare in governance at the national level.