European Partnership for Screening Lawrence von Karsa Quality Assurance Group European Cancer Network for Screening and Prevention International Agency for Research on Cancer Lyon, France
Work Package 6 Screening and Early Detection Package Leader: Ahti Anttila, Finnish Cancer Registry, Helsinki Focal point & technical support: Dr Lawrence von Karsa & Maria Fernan, IARC, Lyon Associated partners: FCS, Cancer Society of Finland NEN, Netherlands Standards Organisation CSISP, Centro Superior de Investigación en Salud Pública (CSISP), Valencia VAZG, Flemish Agency on Care and Health SEF, NHS Sefton IOL, Institute of Oncology, Ljubljana AOSGB & CPO, San Giovanni Battista University Hospital, Turin In collaboration with other work packages, particularly: Work Package 5 - Prevention
European Partnership Action Against Cancer Screening and Early Detection - Main aim Make screening of appropriate quality, as recommended by the Council of the EU, accessible to all citizens who may benefit. Improve implementation of the Council Recommendation on Cancer Screening by alleviating key barriers.
European Partnership Action Against Cancer Screening and Early Detection - Additional Aim Further added value will be created by promoting synergy between cancer screening and other areas of early detection. Health checks and periodic health examinations can range from early diagnosis to life style; dealing also with many other chronic diseases and health risks than cancer.
THE COUNCIL OF THE EUROPEAN UNION Recommendation on Cancer Screening of 2 December 2003 Over 30 specific recommendations How to implement cancer screening programmes How to maintain appropriate quality of screening programmes How to reach appropriate decisions on new or modified programmes
THE COUNCIL OF THE EUROPEAN UNION Recommendation on Cancer Screening of 2 December 2003 1. Implementation of cancer screening programmes (a) Offer evidence-based cancer screening through a systematic population-based approach with quality assurance at all appropriate levels. The tests which should be considered in this context are listed in the Annex; (b) Implement screening programmes in accordance with European guidelines on best practice where they exist and facilitate the further development of best practice for high quality cancer screening programmes on a national and, where appropriate, regional level;
THE COUNCIL OF THE EUROPEAN UNION Recommendation on Cancer Screening of 2 December 2003 HEREBY INVITES THE COMMISSION: 7. To report on the implementation of cancer screening programmes, on the basis of the information provided by Member States, not later than the end of the fourth year after the date of adoption of this Recommendation, to consider the extent to which the proposed measures are working effectively, and to consider the need dfor further action. ANNEX: pap smear screening for cervical cancer precursors starting not before the age of 20 and not later than the age of 30; mammography screening for breast cancer in women aged 50 to 69 in accordance with European guidelines on quality assurance in mammography; faecal occult blood screening for colorectal cancer in men and women aged 50 to 74.
REPORT FROM THE COMMISSION TO THE COUNCIL, THE EUROPEAN PARLIAMENT, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS Implementation of the Council Recommendation of 2 December 2003 on cancer screening (2003/878/EC) December 2008* http://eur-lex.europa.eu/lexuriserv/lexuriserv.do?uri=com:2008:0882:fin:en:pdf Cancer Screening in the European Union Report on the implementation of the Council Recommendation on cancer screening - First Report* L v Karsa, A Anttila, G Ronco, A Ponti, N Malila, ll M Arbyn, N Segnan, M Castillo-Beltran, M Boniol, J Ferlay, C Hery, C Sauvaget, L Voti, P Autier http://ec.europa.eu/health/ph_determinants/genetics/documents/cancer _screening.pdf *Financial support of EU Health Programme
The European Union today 500 million population 136 million men and women 50-74 yrs. 109 million women 30-60 yrs. 59 million women 50-69 yrs. 27 Member States 15 acceded before 2004 Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, Sweden, United Kingdom 12 recently acceded in 2004 and 2007 Bulgaria, Cyprus, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Malta, Poland, Romania, Slovak Republic, Slovenia,
Estimated number of Persons attending Breast, Cervical and CRC Screening Programmes in the EU by Target Cancer and Programme Type in 2007 Persons attending screening programmes for Programme Type Populationbased Breast Cancer Cervical Cancer Colorectal cancer Total 11,262 97% 7,791 25% 3,519 30% 22,572 41% persons %of persons %of persons %of persons %of X screened X screen- X screen- X screened 1000 1000 ed 1000 ed 1000 Nonpopulationbased 343 3% 23,744 75% 8120 8,120 70% 32,207207 59% Total 11,606 100% 31,535 100% 11,639 100% 54,780 100% Estimates corrected for programmes in rollout phase and for missing data in Austria, Latvia, Greece, and Slovak Republic (all programmes) and in Denmark, France and Spain for cervical screening; and in Bulgaria for CRC screening. Karsa et al., 2008
Work Package 6 Screening and Early Detection The main objectives Improving screening programme implementation Reducing inequalities in screening Regional workshops Exchange of experience and initial consensus on quality criteria for health checks
Further added value Further added value will be created by promoting synergy between cancer screening and other areas of early detection Health checks and periodic health examinations can range from early diagnosis to life style and primary prevention; dealing also with many other chronic diseases and health risks than cancer For many of the health checks, the evidence base is lacking; and many other long established quality criteria for screening are not met aspects pertaining to early detection and prevention of cancer
Description of work (1) Planning and initiation iti of a network of European Schools of Screening Management dedicated to capacity building for implementation and improvement of population-based cancer screening programmes A two-weekweek course curriculum will be developed by experts from key universities and research institutes and from internationally recognized centres of excellence in primary and secondary prevention of cancer. The course will be piloted in 2012
Description of work (2) The literature of inequalities in participation and compliance in screening programmes will be reviewed A survey addressed to the national or regional screening managers will focus on two main dimensions: collection of data suitable to describing and analyzing the existence of inequalities related to related to screening compliance and what kind of interventions have developed to reduce inequalities
Description of work (3) For the health checks, the experience emerged in the Netherlands in developing quality criteria for health checks will be exchanged with other member states and initial consensus on pan-european quality criteria for health checks will be developed This aims to develop a coherent strategy to improve and maintain quality of such services - without recommending premature actions which, for lack of evidence, may be counterproductive
About the deliverables Meetings, audio/teleconferences and networking among partners, collaborating partners, stakeholders, ministries and other authorities, and experts 11 reports [D04-D14] D14] Other exchanges: The international advanced course, audit visit, integration of activities with the European network for cancer screening and prevention
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