PRESS RELEASE
Cancer Screening: from Patients and Clinicians the request for a tougher action to
expand the offer and increase the adherence of citizens
• Paolo Bonaretti, spokesperson for All.Can Italy: “Make Italy a forerunner in Europe on prevention and early diagnosis policies, fully implementing the EU Recommendation on cancer screening”.
• Among the experts’ proposals: introduce prevention as a subject to be taught in schools, digitalize the
screening invitation processes, promote widespread information, and extend the experimental program for the early diagnosis of lung cancer to a structural level.
Rome, February 15th 2024 – Teaching prevention in schools to promote the value of health from an early age, bring screenings closer to citizens as an integral part of self-care, digitalizing and making more efficient the screening invitation processes addressed to target populations, enhancing the involvement of GPs to disseminate more widespread information and encourage a proactive attitude towards screening opportunities, and further extending the experimental program of the Italian Lung Screening Network (RISP). These are some of the priorities shared with health decision makers during the round table “The EU Recommendation on cancer screening as a health priority” promoted by All.Can Italy, the multistakeholder coalition of Patients, Clinicians, Health Experts and Industry, aiming at proposing concrete solutions to improve the pathway of cancer patients, which took place today at the Ministry of Health.
The meeting, which was widely attended by the scientific community and patient associations in the oncology area – including ACTO Italia, AIOM, Europa Donna Italia, Fondazione PRO, LILT, ROPI, WALCE – highlighted the need to identify effective and sustainable ways to get Italy in line with the European Recommendation on cancer screenings¹ calling upon EU Member States to extend already existing screening programs (breast, cervical and colorectal cancer) and to introduce new paths for lung, prostate and gastric cancer. Through cancer screening programs, the health service actively offers, free of charge and systematically, an organized pathway of secondary prevention for early detection of cancer, or its precursors, thus enabling early intervention.
According to the latest OECD “Health at a glance 2023”2 report, cancer is the second leading cause of death in OECD countries after circulatory diseases, accounting for 21% of all deaths in 2021. Lung cancer remains a big killer, representing the first cause of death for both men and women. According to the report, Italy is below the OECD average for both cervical and colorectal cancer screening adherence. In 20223, 43% of eligible women in Italy underwent breast cancer screening, while the coverage for cervical and colorectal screening were 41% and 27%, respectively, and with a clear underperformance of Southern regions.
“It is essential to make Italy a forerunner in Europe in terms of prevention and early diagnosis policies,” says Paolo Bonaretti, spokesperson for All.Can Italy. “In order to do this, All.Can Italy, which has been committed to the efficiency of the cancer patient’s pathway for years now, strongly requests that decision makers take action to implement the new European Recommendation on cancer screening and expand screening programs, starting from experimental pilot projects – as was the case for the Italian Lung Screening Network (RISP) – until they are fully implemented. This is why we are here today, at the Ministry of Health, to try to identify together concrete solutions to improve early diagnosis pathways and implement the indications coming from the European Union”.
A recent study published in Jama Network4 showed that more equitable and widespread access to the
recommended screenings for lung, colorectal, breast and cervical cancers could lead to a significant reduction in cancer deaths, since early detection of the disease offers a better chance of access to more timely, personalized and, in many cases, definitive treatment.
“Primary prevention and cancer screenings are decisive for beating cancer! This is why I consider the increasingly direct involvement of a task force made up of Schools, Families and Media to be strategic. The Lega Italiana per la Lotta contro i Tumori (LILT), a member of the European Cancer League (ECL), is giving priority on the one hand to constantly raising awareness in schools, spreading the culture of prevention as a way of life, and on the other hand to intensifying the operations of its diagnostic clinics dedicated to secondary prevention,” says Francesco Schittulli, LILT president.
“In Italy there is room for extending the screening programs offered by the health service, but above all to increase citizen participation,” explains Rossana Berardi, AIOM (Italian Medical Oncology Association) Treasurer and Director of the Oncology Clinic at the University of Marche. “The starting point can only be a paradigm shift towards greater investments and focus on prevention, from a very young age, by introducing it as a subject in schools. At the same time, more action is needed, also taking inspiration from the good practices successfully introduced in some realities and published in the literature. The digitalization of the invitation and booking processes, replacing the paper letter, and the use of reminders via mobile phone (WhatsApp, Mail, App) have proved to be effective in improving the use of screening. Decisive factors are also awareness-raising initiatives aimed at the population and the action of health professionals, in particular general practitioners, to inform about prevention opportunities, intercept high-risk individuals, such as heavy smokers, and encourage voluntary participation in active screening programs”.
In Italy, 395,000 new cancer diagnoses are expected in 2023³, the most frequently diagnosed disease being breast cancer (55,900 cases), followed by colorectal cancer (50,500 cases) and lung cancer (44,000 cases).
“Scientific studies have shown that screening using low-dose chest CT in heavy smokers can reduce lung cancer mortality by 20%. Hence the opportunity to expand national cancer prevention programs to this cancer as well, as indicated by the European Recommendation,” explains Silvia Novello, president of WALCE (Women Against Lung Cancer). “The Italian Lung Screening Network (RISP), born in 2021 with the aim of recruiting 10 thousand eligible volunteers, of which more than 8 thousand have already undergone the first scan, demonstrates the feasibility of the initiative on the national territory and the good adherence by citizens. The program has added value in that it combines secondary prevention (with the use of CT scans) with primary prevention (with tobacco cessation programs). The further extension of this ministerial program, which is currently active in 18 centers and 15 Italian regions, to the point of making it structural, could really enable a paradigm shift in the fight against lung cancer”.
In addition, the opportunity to set up pilot screening programs based on the search for documented hereditary-familiarity must be considered, especially linked to the BRCA1 and BRCA2 genes which, in addition to breast and ovarian cancer, may be linked to other types of cancers, including prostate cancer.
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Notes
1 https://data.consilium.europa.eu/doc/document/ST-14770-2022-INIT/it/pdf
2 Health at a Glance 2023. OECD INDICATORS: https://www.oecd-ilibrary.org/docserver/7a7afb35-en.pdf?expires=1707819627&id=id&accname=guest&checksum=8F843FD758EF43F0020312EC9232B568
3 AIOM, I numeri del cancro in Italia 2023: https://www.aiom.it/wpcontent/uploads/2024/02/2023_AIOM_NDC-web_def.pdf
4 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2812260?utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamanetworkopen&utm_content=wklyforyou&utm_term=112223&adv=000