Improving oncological care organization in Poland-The 2015 reform evaluation in the context of European experiences

Cancer is one of the leading causes of morbidity and mortality worldwide with a significant economic impact which has been increasing in recent decades. Numerous expert groups and/or international organizations have developed guidelines on how to build effective cancer control mechanisms, while in the European Union the majority of countries have developed national programmes. In Poland, cancer is the second leading cause of death. Compared with other European countries, Poland is characterized by a relatively low cancer incidence ratio, yet in terms of mortality and survival ratios, the situation is much worse than the average. On 1 January 2015, an oncological therapy fast track was implemented in Poland, popularly known as the "oncological package." Its formal objectives were to improve access to and systemize the process of cancer diagnostics and treatment. The reform introduced some of the solutions existing in other European countries, including waiting time limits, patient pathways, multidisciplinary medical consultations, and a care coordinator position. The preliminary evaluation analyses suggest that after the reform implementation the average waiting time for diagnostics and treatment for patients covered by the new system was significantly shortened in comparison to those excluded. Further research evaluating the reform impact on quality and/or comprehensiveness of care are needed.