Contact information

Address: Strandboulevarden 49, DK-2100 Copenhagen Ø, Denmark
Telephone : +45 35 25 75 00, fax +45 35 25 77 01, www.cancer.dk
Managing Director: Mr. Leif Vestergaard Pedersen (lvp@cancer.dk)
President of the Board: Professor, MDSc Frede Olesen

Structure of the organisation

The Danish Cancer Society is a private, non-governmental, non-profit organization. The Danish Cancer Society has about 600 employees working with cancer prevention, cancer research and cancer rehabilitation. The Danish cancer Society was established in 1928. Its vision is “Life without cancer”. The vision is being realised by

1. Prevention of the development of cancer
2. Offering the possibility of cure
3. Helping those effected

With its populist base, expertise and skills achieved through research, patient support, prevention and information activities DCS aims to

• Monitor and safeguard patients rights
• Identify problems and obstacles
• Offer professional and political advice
• Specify goals and possible solutions
• Promote and head development activities required to reach its goals
• Involve relevant parties
• Monitor and record results 

More than 452.000 Danes are members of the Danish Cancer Society which is a democratic organization based on voluntary work in local committees in the 98 municipalities and the 5 regions.
The voluntary committees at both levels are engaged in positive dialogues with the authorities on matters concerning cancer patients and prevention. In 2009 the total of 35.000 people worked as volunteers for the Society.

Finances

As far as concerns fundraising and income The Danish Cancer Society had an income of 87.6 million Euros in 2009. Inheritance accounted for 23.3 million Euros, lotteries accounted for 7.7 million Euros, and the annual door-knocking campaign  carried out by volunteers counted 5.2 million Euros. Only 7% of the Danish Cancer Society´s proceeds in 2009 came from public funding. This by and large corresponds to the VAT amount returned to the government.

In 2009, the Danish Cancer Society distributed costs on the following target areas: Research 37.5 million Euros; patient support: 16.6 million Euros; prevention and information: 11.3 million Euros; administration: 4.2 million Euros.

Research

The Danish Cancer Society's research pivots on two key areas: biological, experimental research and epidemiological research. In 2008, Danish Cancer Society researchers published more than 200 articles in leading international scientific journals.

Institute of Cancer Biology

The aim of the Institute of Cancer Biology is to carry out research intended to understand the molecular mechanisms underlying cancer and to bridge the gap between basic and clinical research for the benefit of the patient.

The Institute consists of six departments: Cell Cycle and Cancer, Proteomics in Cancer, Molecular Cancer Biology, Apoptosis, Breast Cancer and Laboratory of Cancer Genomics. In addition, there are two research centre’s affiliated to the Institute: The Danish Centre for Translational Breast Cancer Research (http://www.dctb.org/) and the Centre for Genotoxic Stress Research (www.genotoxic.dk).

The main scientific achievement of the Centre for Genetic Stress Research was a completion of a screen of the entire human genome for genome caretakers and putative novel cancer genes. This project combined high-content microscopy with gene knockdown by siRNA microassays. Amongst the positive scoring genes, the RNF 168 ubiquitin ligase emerged so far as the strongest and most interesting new factor intimately involved in protecting our genomes against DNA damage assaults.

Heat shock protein 70 (Hsp70) is a cancer-associated stress protein that protects cancer cells against various forms of cell death by inhibiting the leakage of enzymes from lysosomes to the cytosol. The researchers from Dept. Apoptosis have now revealed the mechanism by which Hsp70 stabilizes the lysosomes.

Some women develop resistance to anti-hormone treatment. Researchers in the Department of Breast Cancer have found that a combination of anti-hormone treatment and treatment against the HER receptor-system might prevent the resistance.

Researchers from Laboratory of Cancer Genomics have developed a new and improved method for noninvasive detection of bladder cancer. A specific set of genetic biomarkers in cancer cells in the urine allows for the diagnosis.

The Institute has participated in the EU Advisory Group on Health Research and in the establishment of European Academy of Cancer Sciences and European Partnership for Action against Cancer.
Julio Celis, the Director of the Institute, and Jiri Bartek, Head of Dept. Cell Cycle and Cancer have been elected to the European Academy of Cancer Science.

An international advisory board has evaluated the scientific activities of two of the Institute departments. The result was very encouraging for the Institute.

Institute of Cancer Epidemiology

The main objectives of the Institute of Cancer Epidemiology are 1) to search for yet unknown causes of cancer in the environment and in our genes and 2) to investigate and describe serious negative consequences of treatment for cancer among cancer survivors. While the first purpose may help health professionals to more effectively prevent the occurrence of new cases of cancer in the population, the second purpose may help physicians to adjust and individualize the treatment for cancer, so not only the likelihood of survival is a measure of success, but also quality of life.

The Institute consists of seven research groups within genetics, diet and lifestyle, psychosocial cancer research, virus and hormones, occupational cancer, environmental exposures, and sta-tistics. The main outcome of the work at the Institute is new and original research findings publishable in high-quality international research journals using peer review. In 2009, the Institute had a total of 151 such publications.

Important achievements in 2009
1) A study of 54,362 women with infertility problems referred to Danish fertility clinics during 1963-1998. The study indicated no link between treatment with fertility drugs and the risk of ovarian cancer (as otherwise feared) (Br Med J 2009;338:b249.
2) A study showing that plasma concentrations in the general Danish population of perflourooctanoate og perflouroactanesulfonate (Teflon), which is extensively used in modern society for their antiwetting and surfactant properties, is unrelated to risk of prostate, bladder, pancreatic, or liver cancer (as otherwise feared) (J Natl Cancer Inst 2009;101:605-9.
3) A study of the risk of hospitalization for depression among approximately 600,000 Danish inhabitants previously treated for cancer. The study confirms an increased risk, and the authors point to the need for improved surveillance and early detection of psychiatric disease in cancer survivors (J Clin Oncol 2009;27:1440-5).
4) A study of brain tumor incidence rates in Denmark, Finland, Norway, and Sweden during the period 1974-2003 when mobile phone use became exceedingly prevalent; no increasing time trend was observed which could be allocated to the use of mobile phones (J Natl Cancer Insti 2009;101:1721-4).
5) A study of supplemental intake of beta-carotene, folate, vitamins C and E, and risk of urothelial carcinoma in 55,000 Danish men and women: The analysis indicated no preventive effect on urothelial cancer of these micronutrients (as otherwise hoped) (Eur Urol 2009;56:764-70).  

More information about the Institute of Cancer Epidemiology can be obtained at http://www.cancer.dk/epi

Unit for Documentation and Quality

In August 2007 the Unit for Documentation and Quality was established in The Danish Cancer Society as a consequence of public critique of the quality of Danish cancer care. The main objective of the unit is to strengthen the quality of the entire journey of the cancer patient by monitoring quality from the perspective of the patient, surveying professional and organizational performance, gaining knowledge and providing specific proposals for improvement. Quality is conceived in three dimensions: clinical, organizational and patient experienced quality. The unit also collects and provides information about international developments, so that new scientific results, organizational improvements, and “best practice” from cancer care may be implemented in the Danish health care system.

The main four focus areas of the unit are:

• The Patient's GPS - development of a website with information on cancer treatments for patients
• The experiences of cancer patients - developing an IT system for systematical collection and dissemination of patient case stories
• Monitoring the quality of cancer care – several monitorisation projects. Among them a large scale survey of Danish cancer patients (The Barometer Query) aimed at pinpointing areas for improvement of cancer care
• Patient Safety – several projects regarding developing and disseminate knowledge about treatment risks to patients and health care professionals and to engage the health care system towards further safety measures.

Among other current projects are:

• Follow ups – the Quality Unit is engaged in redesigning the follow up procedures of cancer patients
• Overall organization of cancer services
• Facilitating research on different aspects of the patient pathway (eg from symptom to treatment, controls after end of treatment, continuity of cancer care)
• Involvement of patients in their own care and in decision making within the health care system.

Patient Support

The preparation of National Cancer Plan III and our collaboration with Danish municipalities on cancer rehabilitation are two tasks that have played a central role in our work in 2009.

The Cancer Plan III has five main issues: 1) cancer prevention, 2) early detection of cancer, 3) rehabilitation, 4) palliative care and 5) user involvement.

The Department of Patient Support has especially been involved in the work regarding cancer rehabilitation and palliative care, where the plan focuses on coordinated patient pathways and collaboration between health care sectors. We have stressed, that patients should be screened for rehabilitation and palliative needs at appropriate steps during the course of their disease and treatment. Other important issues are education and research.

The plan also points to the importance of including the user perspective in health care plan-ning. The Department of Patient Support is current planning an education program for user groups.

An ongoing goal of The Department of Patient Support is to make the Danish municipalities establish specific rehabilitation programmes for cancer patients.  In 2009 the Department of Patient Support has been coordinating the evaluation of 11 cancer rehabilitation projects in 15 municipalities. Key experiences from the projects show that it can be difficult to include par-ticipants, that different municipalities may have very different approaches to cancer rehabili-tation, and that the coordination between sectors and departments is a challenge. 

The Department of Patient Support has started to collaborate with municipalities through our 15 local counseling centers all over Denmark. The collaboration includes education of muni-cipality staff, implementation of rehabilitation activities, patient education and other activities.

Prevention

Smoking
From August 15th 2007 a law on smoke free environments banning smoking in the workplace, indoor public areas, and institutions like schools, public transport and restaurants came into force in Denmark. Even if the law is incomplete and allows smoking in one-person offices, special rooms for smoking and smoke stations and in bars less than 40 square meters in area, it has had a positive effect in de-normalizing smoking. Smoking prevalence is rapidly declining and less than 20 % of the adult population consider themselves as smokers, and even more positively 2/3 of the population wishes stronger regulations limiting smoking. The law was up for revision in 2010, but this has been postponed. The Cancer Society continues its activities with education of smoking cessation counselors; internet and school based programs against smoking and for stopping smoking, and launches a new internet based cessation program in 2010. Activities to map and highlight involuntary exposure to tobacco fumes collecting and evaluating the scientific evidence continues.

Sun Campaign
In order to reduce the increasing number of skin cancer The Danish Cancer Society and TrygFonden has launched a 10-years campaign ”Lower the sun between 12&15” with the aims of providing information, structural changes, sun smart tools, new cultural standards, better labeling and legislation to the public. The campaign uses new media communicating messages, such as social networks on Facebook, MySpace with video and music clips etc. targeting the younger generations. The campaign has also targeted sun-beds, based on a survey showing that young girls in particular are frequent users and a rapidly increasing melanoma incidence increase in younger ages. It is now publicly known that the industry is failing to comply with regulations, UV exposure is exceeding the accepted limits in the majority of public accessible solariums and the government control is insufficient.  The Cancer Society is advocating for a ban for use of individuals below 18 years of age as instituted in other EU countries. Several public swimming pools and other leisure facilities owned by the municipalities have decided to close their offer of sun beds on their premises. From 2010 the campaign also got funding for a research arm aimed at analyzing and publishing evidence on the effect or lack of effect from the various campaign elements

HPV vaccination campaign
Some 200 young girls were appointed ambassadors to promote HPV vaccination in their schools and local settings after having received education by the Cancer Society professional staff. The campaign was supported by educational and information material, and tag on to the decision from the health authorities to offer the vaccination for free for 12-14 year olds. The Cancer Society now advocates for vaccination up to age 26 thus covering the age-span accepted by the authorities for use of the vaccine.

Whole grain campaign
A new campaign and partnership on whole grain was launched in 2008 to combat obesity and thus improve public health. The campaign promotes whole grain products and advice on a well balanced diet based on fiber and whole grain. The campaign is a collaboration between producers of whole grain products, the retailers, the national food agency and more health promoting organizations including the Danish Cancer Society, who host the campaign secretariat, as also done for the “six a day” campaign promoting a healthy diet with fruit and  vegetables and restriction of  red meat.

Physical activity
A major contract was signed in 2008 involving the cancer society in the creation of a large open space around Copenhagen stimulating physical activity. It concerns the old fortification of Copenhagen surrounding and passing through several communes around the center build before year 1900. It is today an underutilized recreational area. The project area passes several communes in the greater Copenhagen and the project thus is a vehicle for a comprehensive preventive action using structural changes in the park-like area that stimulates leisure time physi-cal activity. The project will include bike paths, jogging paths, eventful open areas, and will be combined with school activities on physical activity. The project runs to 2011 and is funded by Realdania, and public authorities.

Nordic Activities

NORDCAN program and database, a joint cancer incidence and mortality database in the Nordic countries, is a NCU supported strategic activity made available by the Association of Nordic Cancer Registries. A web-based version was launched June 2007 with choice of English or national language, with data from the start of the registers and to the newest available data, and with possibility of easy presentation in tables and graphs. In March 2008 prevalence data as well as data from the Faroe Isles were included. In 2009 the software was expanded with a module for forecasting cancer incidence and mortality into the future. The software produce cancer stat fact sheets with the latest key data for each country and cancer type with one simple click and it is updated regularly and now includes data for 2007 and for most countries including 2008. The cancer stat fact sheets for Denmark will be available at the web-pages of the Danish Cancer Society for the specific cancer types to ensure newest possible updated data. The software is now internationally recognized and used at several Universities in Europe and the USA, and will be used for the European cancer incidence and mortality provided by IARC, WHO.

Based on NORDCAN data a comprehensive project on time trends in Nordic cancer survival was analyzed. The results are reported in 13 peer reviewed papers appearing together with a paper on the NORDCAN database and software in ACTA ONCOLOGICA in the spring 2010. These papers will form the basis for regularly updated survival comparisons between the Nordic countries in order to follow the effects of the improvement in cancer care after cancer plans are instituted in almost all Nordic countries.

To explore the reasons behind the lower Danish rectum cancer survival, population based data from national clinical registers in Norway, Sweden, and Denmark, collected clinical information in Iceland and Finland and enhanced cancer register data from Scotland was published on rectal cancer  in 2009.  “High resolution” comparisons between Sweden and Denmark for breast cancer have earlier been published showing a worse stage distribution in Denmark and national coverage of breast cancer screening in Sweden as the main factors behind the worse Danish breast cancer survival. Similar studies are under way for colon and prostate cancer and are ex-pected to be published in 2010.

The planned study on predictions of cancer incidence and mortality under different prevention scenarios was postponed due the NCU initiated activity on coast of cancer care carried out by SINTEF. In order to support this project a special prediction of prevalence of cancer was needed. The ANCR team in charge of the incidence prediction project accepted the challenge and changed the work plan accordingly. Prevalence predictions will be available for the estimation of the current and future economical consequences of cancer in the Nordic countries will be based on scientifically sound prevalence predictions done by the ANCR.

Nordic summer school in Cancer Epidemiology
The 11th Nordic summer school in cancer epidemiology for pre-graduate students was successfully completed with the winter course in Finland 2010 for some 25 students. The assessment by the students – of which a few were postgraduate and PhD student were excellent, and the school continues with support from the NCU on the bi-annual schedule with a 2 week theoretical course August every second year followed by practical hands on research in one of the Nordic epidemiological centers and a winter seminar with presentation of results. The school is unique and a very important contribution in training and attracting young researchers to the cancer field. In order to assess the impact of the school in science a literature search was done on participants names from the first 10 summer schools. Altogether 1257  publications has emerged from the 152 students we have followed, naturally with publications activity related to the number of years since graduating from the school.
 

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