The Evidence Exists for Screening

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LUNG CANCER & EARLY DIAGNOSIS: The Evidence Exists for Screening Sofia, 22-23 April 2018

OVERVIEW The Bulgarian capital of Sofia will host a conference on lung-cancer screening in April, at the same time as Bulgaria holds the rotating EU Presidency. In association with the Brussels-based European Alliance for Personalised Medicine (EAPM), the conference will be run by national affiliate the Bulgarian Alliance for Precision and Personalised Medicine. Bulgaria holds the EU presidency for the first time since it joined the bloc on 1 January 2007. The Bulgarian Alliance has taken a lead in putting access and earlier diagnosis as a top priority in its own region as well as in the Balkans. Sofia sees it as a very important priority to focus on screening and prevention, especially in respect of such a killer disease. One of the aims of the conference is to put forward a recommendation to be adopted by the EU Council to facilitate the The title of the conference is Lung Cancer & Early Diagnosis: The Evidence Exists for Screening and it will take place from 22-23 April. drawing-up of lung cancer screening guidelines by an Expert Group. This will take into account the pros and cons of screening programmes in other disease areas, including breast, colorectal and cervical cancers. It is anticipated that the conference will conclude with the signing of a declaration for this purpose. It is far from new territory for EAPM: earlier in 2017, the Alliance held a high-level conference on lung-cancer screening and guidelines, and also published a White Paper on the subject for dissemination at EU level. The board of the Alliance has made prevention, screening and early diagnosis as one of its main priorities going forward, a move echoed by its colleagues and partners in Bulgaria.

SUNDAY, 22 APRIL 18.00 Drinks Reception & Welcome to Sofia Conference Launch: Welcome to Sofia, Bulgaria: Jasmina Koeva, Bulgarian Alliance for Precision and Personalised Medicine Denis Horgan, EAPM Executive Director Jordanka Fandakova, Mayor of Sofia, Bulgaria Maja Manolova, Ombudsman, Bulgaria 19.00 Dinner for Bulgarian Presidency, speakers and sponsors Screening & Early Diagnosis The Evidence Exists Europe is looking at risk prediction models to identify patients for screening, plus determination of how many annual screening rounds are required. The European Respiratory Society and the European Society of Radiology have both recommended screening for lung cancer under the following circumstances: In comprehensive, quality-assured, longitudinal programmes within a clinical trial or in routine clinical practice at certified multidisciplinary medical centres. There have been indications that, while we wait, there is a good case for immediate implementation of carefully designed and well targeted demonstration programmes. Chair: Giulia Veronesi, Humanitas Research Hospital, Milan Andrey Kovatchev, Member of the European Parliament - tbc Matthijs Oudkerk, Scientific Director Centre for Medical Sebastian Schmidt, Siemens Healthineers

08.00-09.00 Registration 09.00 Welcome Jasmina Koeva, Bulgarian Alliance for Precision and Personalised Medicine Denis Horgan, EAPM Executive Director Opening Plenary: Politics Meeting Science The Need for Action It is at the very least surprising that the biggest cancer killer of all does not have a solid set of screening guidelines, or globally introduced screening programmes. As long ago as December 2003, EU health ministers unanimously adopted a Recommendation on cancer screening, which acknowledged both the significance of the burden of cancer and the evidence for effectiveness of breast, cervical and colorectal cancer screening in reducing the burden of disease. At that point, EU guidelines updated and expanded for breast and cervical cancer screening had already been published by the Commission, while comprehensive European guidelines for quality assurance of colorectal cancer screening were being prepared. Nearly 15 years on and incidence and mortality rates of cancers still vary widely across the EU, reflecting a major health burden in various Member States, often splitting large and smaller countries along with richer and poorer nations. EAPM & BAPPM has consistently called for concrete actions at the EU level and Member State level, as less-than-half of examinations performed as part of screening programmes actually meet with all the stipulations of the original Recommendation. This cannot be allowed to happen with lung cancer. Session Chair: Marius Geanta, President, Centre for Innovation in Medicine

09.15 Key Note Address Oleg Petkov, Deputy Minister for the Bulgarian Presidency of the Council of the EU 2018 (TBC) Prof. Elke Anklam, Director, European Commission's Joint Research Centre, Directorate F: Health, Consumers & Reference Material" 09.45 A Call to Action for Lung Cancer Screening Dr Giulia Veronesi, Humanitas Research Hospital, Milan 10.15 The promise of national screening for Lung Cancer Patients Harry de Koning, Department of Public Health, Erasmus MC, Rotterdam, Netherlands 10.30 Comprehensive Genomic Profiling in the Lung Cancer Diagnosis Dr. Abed Agbarya, Head of Oncology Assuta medical center, Tel Aviv, Izrael 10.45 Making Innovation a reality for patient Serban Ghiorghiu, Vicepresident Clinical for Oncology, AstraZeneca 11.00 Is it feasible? Dr.Lachezar Ivanov, Deputy() Chair, Health Committee, Bulgarian Parliament 11.15-11.30 Coffee Break

11.30 13.00 Session 1: Lung Cancer Screening: The Added Value for Society Lung Cancer Screening - The Added Value for Society Earlier diagnostics and earlier treatment has many benefits, among them fiscal, because while cost is a major issue and there are key questions about the cost-effectiveness of new and even existing treatments better diagnostics will ease the burden on health-care systems in two ways. Firstly, it will allow a more preventative approach in that gene technology will flag up the likelihood of a particular individual developing a particular disease and provide a good idea of how it will develop, thereby encouraging early intervention. Secondly, efficacious treatment means patients are much less likely to require expensive hospital beds and are more able to continue working and contributing to economies. Session Chair: Denis Horgan, Executive Director, EAPM 11.30 Position of the EU on Lung Cacer Screening Dr Giulia Veronesi, Humanitas Research Hospital, Milan 11.50 Urgent Need for Screening Ass. prof. Dimitar Kalev, Head of Medical Oncology and Radiology, Specialized Hospital for Active Treatment of Oncological Diseases, Varna 12.10 Structured cooperation between health systems: The Role of Screening Guidelines Tit Albrecht, Institute of Public Health, Slovenia Josep Borras, Spanish Cancer Strategy Josep Borras, Spanish Cancer Strategy Q&A

12.45-13.45 Lunch 13.45-14.45 Session 2: EU Screening Guidelines:Colorectal, Breast, Cervical Benefits to Society One of the aims of the conference is to put forward a recommendation to be adopted by the EU Council to facilitate the drawing-up of lung cancer screening guidelines by an Expert Group. This will take into account the pros and cons of screening programmes in other disease areas, including breast, colorectal and cervical cancers. Session Chair: Denis Horgan, EAPM Executive Director 13.45-14.05 Comparative Overview of the Screening Programs in Bulgaria Prof. Zdravka Valerianova, University Specialized Hospital for Active Treatment in Oncology, Sofia, BG Q&A 14.05-14.25 Patient Perspective on Screening (tbc) Stanimir Hasurdjiev, Secretary-General, Patient Access Partnership, Q&A 14.45-15.05 Will Lung Cancer Screening bring Added Value Speaker to be confirmed 15.05-15.20 Q&A 15.20-15.45 Coffee Break

15.45-16.45 Closing Session: Enabling quality through Lung Cancer Screening: Next Steps Findings in both Europe and the US strongly suggest that lung cancer screening works. There is hard evidence, although debate continues about the best way to implement screening of this kind, and even how to properly evaluate cost effectiveness. Guidelines could help to tether costs, by bringing in improvements to the efficiency of screening methodologies and, thus, programmes themselves. Guidelines must be put in place to allow countries to set-up quality assured early detection programmes for lung cancer, possibly through increased public-private partnerships. Session Chair: Dr Giulia Veronesi, Humanitas Research Hospital, Milan Dr. Jasmina Koeva, Chair, Bulgarian Alliance for Personalized and Precision Medicine Support of the European Parliament: Alojz Peterle MEP, European Parliament, Former Prime Minister of Slovenia High Level Panel Discussion: (tbc) Kiril Ananiev, Minister of Health, Bulgaria (tbc) Lukasz Szumowski, Minister of Health, Poland (tbc) Sorina Pintea, Minister of Health, Romania 16.45-17.00 Conclusions Launching of a Declaration to call on the Commission to set up an Expert Group to draft Guidelines