On February 12th debate “Oncological preventive programs – directions of change”, organized in cooperation with All.Can Polska by Rynek Zdrowia (Polish most influential healthcare system portal) was held. The topic of prevention has always been one of the key issues for All.Can Polska, and a report devoted to this area will be published soon – „Screening Oncology Programs in Poland implemented in 2022-2024. Analysis of the problem, experts recommendations”, whose co-authors participated in the debate and shared their conclusions in the document. The data is alarming – as many as 62% of Poles declare that they have never had any preventive examination! The invitation to the debate on the current situation and necessary directions of action was accepted by:
- Joanna Chorostowska-Wynimko, Head of the Department of Genetics and Clinical Immunology at the Institute of Tuberculosis and Lung Diseases in Warsaw (author of the comment in the report)
- Joanna Didkowska, Head of the Department of Epidemiology and Primary Prevention of Cancer at the National Institute of Oncology in Warsaw, Head of the National Cancer Registry (author of the comment in the report)
- Senator Beata Małecka-Libera, Chairwoman of the Senate Health Committee
- Aleksandra Rudnicka – Spokesperson of the Sanitas Association (author of the comment in the report)
- Dr Małgorzata Sobotka-Gałązka, Dean of the Postgraduate Education Center and Director of the Institute of Management in Health Care at Lazarski University (author of the comment in the report)
- Marek Augustyn, Deputy President of the National Health Fund
- Paweł Koczkodaj, from the Department of Epidemiology and Primary Prevention of Cancer at the National Institute of Oncology in Warsaw
Moderation: Iwona Bączek, Rynek Zdrowia journalist
Prevention is one of the priorities of the Polish Presidency of the EU Council. As Aleksandra Rudnicka rightly noted – We must take action to change the unsatisfactory situation in the area of disease prevention, including oncological diseases. Education, coordination and monitoring are necessary – we do not get tested as a society, 46% of Poles cannot name preventive tests, about 1/3 of people do not know that tests are available free of charge. There is no nationwide institution responsible for prevention, activities are scattered and therefore ineffective. That is why coordination of activities and education are needed, broad, diversified depending on the target group. And active invitations to tests!
Prof. Didkowska drew attention to the too low number of people reporting for preventive tests – Over 60% do not go for check-ups. In addition, attention should be paid to their quality, because performing cytology in a private office does not guarantee that the test was performed and assessed correctly. The Professor referred to the number of people developing cancer – currently it is over 180 thousand cases per year! One of the biggest problems is lung cancer and this concerns both men and women.
Prof. Chorostowska-Wynimko spoke about lung cancer as a medical and social problem – We recognize about 21 thousand new cases annually, unfortunately about 85% of them are diagnosed at a late stage, which reduces the chances of effective treatment. As a result, almost 21 thousand patients die each year. Screening for lung cancer – the use of low-dose computed tomography as part of the screening program allows for a very significant reduction in lung cancer mortality in the high-risk group. Currently, a European project is being implemented in one of the regions of Poland, the task of which is to develop principles for the effective implementation of screening tests in order to improve the recognition of lung cancer in Poland as quickly as possible. The Professor raised the issue of education as one of the main factors that can improve reporting – education not only of the society, but also of medical personnel, especially primary health care.
Dr Gałązka-Sobotka spoke about the funds that are allocated for prevention – This is only 2% of health care expenditures with the European average of about 5%. Change in this area requires verification of priorities and appropriate political decisions, because health is the most valuable and important capital. In many areas of health care, we have significant successes, e.g. in access to modern therapies. However, we have a big challenge in the area of prevention and without changes in this area, focusing on remedial medicine, we will not improve the health of society. Dr. Gałązka-Sobotka drew attention to the fact that many of us simply do not know what preventive tests should be performed. – An individual plan of preventive tests available through, for example, individual online patient account would be a good solution, help in increasing the number of people reporting for tests.
Prof. Koczkodaj referred to the National Oncology Strategy, which devotes a lot of space to prevention. As he said – Without appropriate actions to counteract the obesity epidemic, which is a risk factor for cancer, without reducing exposure to tobacco smoke, the scale of cancer incidence will increase. Exposure to tobacco smoke remains a huge challenge, and it is a fully modifiable factor. Unfortunately, despite the growing interest of smokers in obtaining professional help in the process of quitting smoking, there are only 2 smoker assistance clinics in Poland. Hence the plan to urgently organize more facilities. In addition, we do not assess the effectiveness of educational campaigns, so we do not know how to modify them, improve their effects. As Prof. Koczkodaj pointed out – 19% of Poles believe that prevention will not save lives. So we need education to convince society to do research! And education should start at school, health education should be mandatory – appealed the Expert.
Senator Małecka-Libera pointed out that we have huge needs in terms of prevention and we need health education as a society. – And this education should go beyond the school framework, it should also take place at home, in the social space. It should also be conducted by appropriately trained people. The Senator referred to the activities of the Senate of the Republic of Poland, which is intensively involved in the promotion of prevention, including holding talks on the vaccination schedule, educating citizens about the tests that should be performed and about the financial resources that need to be allocated for prevention, because without increasing the scale of expenditure for this purpose, nothing will change.
Deputy President of the NHF, M. Augustyn referred to the problem of access to the best quality tests, which, as he indicated, are high on the list of priorities of the National Health Fund. He recalled the plan to introduce a molecular screening test and a liquid cytological test to the cervical cancer prevention program this year. He also drew attention to the increase in the age limit by 5 years for mammographic and cervical cancer tests.
We hope that the conclusions and recommendations of the participants will be noticed by all those who have an influence on the shaping of the healthcare system in Poland and will be taken into account in the planned activities for the coming months and years.