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Evaluation of cancer patient pathways

In this project, which is a research-based evaluation of the introduction of cancer patient pathways (CPPs) in Norway, we investigate how healthcare personnel work to realize CPPs and how patients experience services when being in included in CPPs.

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The project's aim is to gain knowledge on how patients and service providers experience CPPs. Additionally, it seeks to assess whether the introduction of CPPs aligns with  the health authorities ' intentions..

Three main themes are explored:

  • Patient satisfaction and user participation in the CPPs.
  • Collaboration between the specialist health services and GP's and private contract specialists.
  • Management and organisation within hospitals, including division of tasks and responsibilities in cancer diagnostics and treatment.

The project focuses on CPPs for four types of cancer:  breast, prostate, and lung cancer, as well as malign melanoma. .

Design and methods

This is a health services research project that utilises qualitative research methods such as interviews and text analysis. Data comprises:

  • Interviews with patients who have a diagnosis covered by the four above-mentioned pathway courses.
  • Interviews with healthcare personnel in hospitals (doctors, nurses, pathway coordinators etc.), GP's and private actors/contract specialists.
  • Analysis of patient information material


Cancer patient pathways (CPPs) were introduced in Norway in 2015. CPPs are time-bound standardised care pathways that describe the organisation of and responsibilities for diagnostics and treatment, as well as communication with the patient and next of kin. The aim is to ensure that cancer patients experience a well-organised, coherent and predictable pathway without any delays in assessment and diagnostics caused by non-medical reasons.

There is little research-based knowledge about how patients experience getting examination/treatment for cancer organized through a package process. There is also little systematic knowledge about how service providers work to implement patient patway processes for cancer, and what kind of organizational steps (both internally in hospitals and across organisations) are made when organizing services through pathway processes.


Håland, Erna; Næss, Siri Christine Kvernmo; Solbjør, Marit; Gilstad, Heidi; Melby, Line Kari. Forhandling, koordinering og kvalitetssikring: Pakkeforløpskoordinatorers arbeid med pakkeforløp for kreft. Norsk sosiologisk tidsskrift 2023, ;Volum 7.(6), NTNU SINTEF.

Gilstad, Heidi; Sand, Kari; Solbjør, Marit; Melby, Line.
Deconstructing (e)health literacy: aspects that promote and inhibit understanding of health information in breast cancer patient pathways.
International Journal of Qualitative Studies on Health and Well-being 2022 ;Volum 17.(1), NTNU SINTEF.

Andersen-Hollekim, Tone Elisabeth; Melby, Line; Sand, Kari; Gilstad, Heidi; Das, Anita; Solbjør, Marit. Shared decision-making in standardized cancer patient pathways in Norway—Narratives of patient experiences. Health Expectations 2021, ;Volum 24.(5) s.1780-1789, NTNU SINTEF.

Håland, Erna; Melby, Line. Coding for quality? Accountability work in standardised cancer patient pathways (CPPs). Health 2021 s.1-18

Melby, Line; Håland, Erna. When time matters: a qualitative study on hospital staff’s strategies for meeting the target times in cancer patient pathways. BMC Health Services, Research 2021 ;Volum 21. s.1-12,

Melby, Line; Solbjør, Marit. Webinar: "Pakkeforløp for kreft" - konsekvenser for pasienter og helsepersonell. Panelsamtale mellom forskere og Kreftforeningen. Webinar - avslutning for prosjektet Evaluering av pakkeforløp for kreft; 2021-03-03 - 2021-03-03, 

Solbjør, Marit; Sand, Kari; Ervik, Bente; Melby, Line. Patient experiences of waiting times in standardised cancer patient pathways in Norway - a qualitative interview study. BMC Health Services, Research 2021 ;Volum 21.(1) s.1-7, NTNU SINTEF UNN.

Håland, Erna; Melby, Line. Koder som representasjon for kvalitet? Helsepersonells arbeid for å forstå, bruke og utvikle koder som representasjon for kvalitet i pakkeforløp for kreft. Helsetjeneste-forskningskonferansen; 2020-03-10 - 2020-03-11, 

Solbjør, Marit; Gilstad, Heidi; Sand, Kari; Das, Anita; Melby, Line.
Shared decision making in standardized cancer patient pathways in Norway – patient experiences. International Conference of Integrated Care, ICIC2020; 2020-09-30, NTNU SINTEF, 2019.

Melby, Line; Håland, Erna. Speedy, predictable and secure cancer care? Introducing cancer patient pathways in Norway. 12th European Public Health Conference; 2019-11-20 - 2019-11-23, SINTEF NTNU.

Key Factors

Project duration

2017 - 2020


The Research Council of Norway

Cooperation partners

SINTEF, Dept. of Health Research, NTNU and NTNU Samfunnsforskning. International cooperation partner is Århus universitet, Center for Forskning i Cancerdiagnostik i praksis.

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