Quality improvement in treatment of patients with Renal Cell Cancer in Denmark. Overview and results from The DARENCA register

BACKGROUND The incidence of Renal Cell Cancer (RCC) is on the rise globally. In the period 1994-2003, the relative five-year survival after RCC in Denmark was 39 percent for men and 44 percent for women. We aimed to describe whether the establishment of a nationwide clinical quality database for RCC was followed by improved care and survival. PURPOSE The purpose of the nationwide quality register in Denmark is to standardize treatment and improve prognosis by documenting the quality of healthcare treatment and contribute to improving prevention, diagnostics, treatment and rehabilitation MATERIAL AND METHOD In Denmark it is mandatory for all departments treating RCC to report relevant quality data on all patients. Every Danish resident has a unique Civil Registration (CPR) number which allow linkage to the national patient register and the pathology register. These registers contain information about all examinations and treatments in Danish hospitals. In a national steering group of the clinical register for RCC, different quality indicators have been selected for monitoring the quality of the treatment. The group chose nine indicators to be measured each year. The group meet several times a year to prepare an annual quality report, which is published and sent to hospitals, healthcare regions and the Danish Health Authority. RESULTS The register was established 1 August 2010 and contains 12.193 new cases of RCC, including 1 091 from the current year (the period 1 August 2022 to 31 July 2023). Over the years, a clear improvement has been observed both nationally and differences between regions and hospital departments decreased and thereby the equality of treatment and outcomes in the country has improved. CONCLUSION Through systematic work with quality results, interdisciplinary collaboration and the introduction of new treatments, we have observed a uniform treatment and increased survival in patients with renal cancer, which is at an international level.