OBJECTIVES: Patient Satisfaction and Quality in Oncological Care (PASQOC®) 2002 was the first assessment in Germany focussing on patient satisfaction in oncology. In 2004 PASQOC® was rerun to assess and observe quality of oncological care over time (2002/2004). Of 49 participating practices and ambulances, 16 were following-up on their 2002 experience. METHODS: All cancer patients presenting at the investigators' practices within a defined recruiting period received the validated questionnaire PASQOC® via mail. Patients' inclusion criteria: German speaking, =18 years, confirmed cancer diagnosis, physical/mental ability to complete self-administered questionnaire. Analysis based on dichotomous 'problem scores' indicating the presence or absence of a problem. These are summed into 13 'dimension scores', each clustering a defined set of questions. Results (2002 figures in brackets): Samples did not differ significantly in structure. The 16 practices recruited n=1639 patients (n=1826), 50.9% women (55.0); mean age 63.6 years (62.4). Comparing 2004 with 2002 it is demonstrated that 5 practices showed overall improvement in all dimensions, 3 practices improved in some, 4 practices improved and decreased, while 4 maintained steady state. Patients of one practice reported much more problems in all dimensions in 2002 than on average. In 2004, the practice presents with only “praxis organisation” being still an issue for patients (+37%). This practice demonstrated an overall better performance based on improvements in 8 out of 13 scales. Problem scores dropped (ie. improvement) especially interperson communication dimensions, ie. patient-physician relationship (-56%), co-management (-32%), involvement of family members (-54%), discussion with other patients (-41%). CONCLUSION: Assessing patient satisfaction over time is one tool to generate a platform for quality assurance in oncological care. The PASCOQ® questionnaire is a tool to assess not only status quo but is also feasible to detect changes in patients' satisfaction with physicians, staff, environment as well as side effects and supportive medication.