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EUROCHIP-2 European Public Health Action on Cervical Cancer Screening

GRELL 2006 - Palma de Majorca . EUROCHIP-2 European Public Health Action on Cervical Cancer Screening . Paolo Baili Unità di Epidemiologia Descrittiva e Programmazione Sanitaria Istituto Nazionale per lo Studio e la Cura dei Tumori. Public Health Program

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EUROCHIP-2 European Public Health Action on Cervical Cancer Screening

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  1. GRELL 2006 - Palma de Majorca EUROCHIP-2 European Public Health Action on Cervical Cancer Screening Paolo Baili Unità di Epidemiologia Descrittiva e Programmazione Sanitaria Istituto Nazionale per lo Studio e la Cura dei Tumori Public Health Program EUROPEAN COMMISSION: HEALTH & CONSUMER PROTECTION DIRECTORATE - GENERAL www.tumori.net/eurochip

  2. EUROCHIP-1 INDICATOR A INDICATOR B INDICATOR C . . . INDICATOR Z Data available Inequalities EUROCHIP-2

  3. EUROCHIP-2 DISCUSSION PLAN COUNTRY 1 COUNTRY 2 COUNTRY 3 COUNTRY 30 ACTION 2 ACTION 3 ACTION 4 ACTION 5 ACTION 6 ACTION 6 ACTION 1 ACTION 3 ACTION 4 EDUCATIONAL ACTIVITY EUROPEAN PUBLIC HEALTH ACTION – early diagnosis Cervical screening EUROPEAN PUBLIC HEALTH ACTION – care & treatment Pilot studies EUROPEAN PUBLIC HEALTH ACTION - prevention Dietary prevention EU CANCER PLAN

  4. Uterus cancers ICD 180: Cervical cancer ICD 182: Corpus uteri cancer ICD 179: Uterus cancers, not specified On the basis of overall national death certificates, it is not possible to analyze mortality from cervical cancer in Europe, since 20-65% of deaths from uterine cancer in largest countries are still certified as uterus, unspecified To estimate cervical cancer mortality we used death rates for uterine cancers (ICD 179, 180, 182) in women aged 20-44, since most deaths from uterine cancer below the age of 45 years arise from the cervix Source: Levi et al. European Journal of Cancer 36 (2000); 2266-2271

  5. UTERUS CANCER STANDARDIZED MORTALITY RATE AGE: 20 – 44 (IN THESE AGES MOSTLY CERVICAL CANCER) European standard per 100,000 http://epicancer.iss.it

  6. UTERUS CANCER (age 20-44) AVOIDABLE DEATHS. 2000

  7. EUROCHIP-2 ACTIVITY: TO ORGANISE A TASK FORCE ON CERVICAL CANCER SCREENING EMERGENCY MILESTONES • Analyze the European guidelines to implement/promote/reconstruct cervical cancer screening in countries with increasing mortality trends • Describe the opportunistic/programmed cervical cancer screening in those countries at present time • Find difficulties and problems with specific assessment studies in these Eastern European countries • Connect all the previous points with other European networks (EUNICE, European Cancer Screening networks)

  8. For countries without programs:ASSESSMENT STUDIES Understand how services for cervical cancer screening and treatment currently are, or could potentially be, organized and delivered Identify the key organizations involved in delivering these services, including potential leaders, coordinators, or area supervisors Define the level of available resources and assess how services could be financed Document the system for requesting and purchasing equipment and supplies, and for improving infrastructure

  9. ROMANIA ASSESSMENT PHASES: COLLECTION OF INFO ON Use of Policies, Guidelines, and Norms Program Management Issues Health Services Information and Education Activities Community Perspectives Laboratory Information Systems

  10. Screening prices VS treatment prices BULGARIA • In Bulgaria the mean value of programme screening for 1 person is around 5 € • Target population: 1.8 million (age 25-60) • Screening interval: 3 years • 5 € * 0.6 million = 3 million € per year BULGARIAN ESTIMATES V. Zlatkov - Bulgaria (2006)

  11. CURRENT SITUATION LATVIA • Prevention examination program (12.2004): • Age 20-35: PAP smear has to be done one time per year initially and, if the results of examination are without the pathological findings, every 3 years • Age 35-70: PAP smear has to be done one time per year • Health care reform aims at driving health care to GPs • BUT: 76% of women felt that they could not trust their GP to perform a PAP Smear (Source: Survey Reproductive health of the population) • ORGANIZATION OF A GROUP OF PRESSURE • PRACTICAL PROPOSAL TO DEVELOP A SCREENING PROGRAM I. Viberga - Latvia (2006)

  12. FIRST RESULTS OF THE NEW ACTIVATEDCERVICAL SCREENING PROGRAM LITHUANIA CANCERS IN SITU EUROCHIP-2 will help the centralization of the invitation system J. Kurtinaitis - Lithuania (2006)

  13. PROBLEMS OF THE ORGANISED SCREENING PROGRAM ESTONIA • Low participation: Only 21.7% of the 12,960 invited women attended the screening • No funds for screening registry • No invitation of women without insurance (~5% of population) • To use experience from other countries to produce successful campaigns • Group of pressure for invitation of women without insurance • Money for starting the organization of screening registry P. Veerus - Estonia (2006)

  14. EUROCHIP-2 TASK FORCE ON CERVICAL CANCER SCREENING EMERGENCY AIMS • To create relations with groups of pressure with national health ministries and with European Parliament • To share information with other networks • For countries without cervical screening programs: to study specific problems for implementation of screening programs and to find solutions to these problems • For countries with cervical screening programs: to help specific activities that at the moment are not subsidize (ex: screening registry, centralisation of the invitation system)

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