DISCUSSIONS and DECISIONS Sophia, 22 nd May 2006 Public Health Program EUROPEAN COMMISSION: HEALTH & CONSUMER PROTECTION DIRECTORATE - GENERAL

BULGARIA: STATE OF THE ART Is organised screening present in the past? YES (up to 1989) Does this program have problems? YES (mortality did not decrease) Is organised screening present at the moment? NO At the moment are we in the position to reorganize the screening program? NO What is mainly necessary at the beginning? Which is the major problem at the moment? a. Political interest Steps to follow: a. MAJOR PROBLEM: To find groups of pressure (Groups like EuropaDonna, Medical Associations…) within the country and at international level b. To find practical proposals necessary to start the reorganization and also to solve problems in the past c. To start with Pilot Program: define the team that could promote and organize the Pilot

ROMANIA: STATE OF THE ART Is organised screening present in the past? NO Is organised screening present at the moment? NO At the moment are we in the position to organize a screening program? NO What is mainly necessary at the beginning? a. Practical proposal considering resources Steps to follow: a. Definition of the program in relation of the resources - Ex. Start at age 30 - Ex. Nurses are less expensive than GP b. Monitor the activity of cytologists c. To use correct indicators

LATVIA: STATE OF THE ART Is organised screening present in the past? NO Is organised screening present at the moment? Announced program (for GP), but none activity At the moment are we in the position to organize a screening program? NO What is mainly necessary at the beginning? Which is the major problem at the moment? a. Reorganization of the system (for pap-smear women prefer to go the gynecologist instead of GP) Steps to follow: a. To define the actors and improve the collaboration between figures involved in the program b. Education: reference with other countries c. To reconstruct the history of a sample of cervical cancer cases. It could be useful to understand which are priorities

LITHUANIA: STATE OF THE ART Is organised screening present in the past? NO Is organised screening present at the moment? YES Which is the major problem at the moment? a. Invitation system is in the hand of GPs. Women are invited if they go to GP Steps to follow: a. Centralisation of the invitation system for a pilot area

ESTONIA: STATE OF THE ART Is organised screening present in the past? NO Is organised screening present at the moment? YES Which are the major problems at the moment? a. Participation b. Non invitation of women without insurance c. Screening registry does not exist

TASK FORCE ACTIVITIES (1) 1.Groups of pressures. Ex: ONDA => European Parliament Meeting with women of the European Parliament (to organize probably in September 2006) Public opinion. Articles on newspapers and women magazines with a local vision 2.Information for local medical associations. EUROCHIP WT Task: Prepare a letter to send to local medical associations 3.Specific recommendations to Health Authorities at national level and at international level. EUROCHIP WT Task: paper for Network of Health Authorities. In the PAPER we will also invite the Health Ministries to inform the EC about the cervical cancer screening programs activated (info on structure, organization, results) WT: Working Team

4.Participation in the chapter on cancer in the EC Health Book 5.Meeting devoted to the discussion of technical aspects Probably period: before the end of Main tasks: Is our work compatible with European guidelines? Study of the possibility to develop a centralized information system (invitation, recall, monitor) in each country 6.To Share information. All information, all presentations will be available at the web-site 7.To change information with EUNICE in order to have standardize collection of data from new screening programs (it is really important to know the activities of the other European projects on this matter in order to avoid duplications) TASK FORCE ACTIVITIES (2) WT: Working Team