European Union against cancer The EUROCHIP project 1st International Cancer Control Congress Vancouver, October 2005 Public Health Program EUROPEAN COMMISSION: HEALTH & CONSUMER PROTECTION DIRECTORATE - GENERAL

How can we develop national cancer control strategies to support maximum impact with defined populations? Health for all by year 2000

LIFE EXPECTANCY TRENDS IN EUROPE Inequalities in health increased increased in the last 30 years Source: Micheli et al Annals of Oncology, 2003

CANCER INEQUALITIESIN EUROPE INCREASED CANCER INEQUALITIES IN EUROPE INCREASED ALL CANCERS COMBINED - RR (MAX/MIN) Year Incidence M 1.9 W 2.2 Mortality M W yrs Survival M W 2.0 Sources: EUROCIM - EUROCARE

CANCER CONTROL SUGGESTIONS Why? To fight inequalities How? With translational research What? Population based data & disease natural history network permanent consensus conference permanent consensus conferenceACTIONS

SUCCESSES IN RESEARCH HAVE NOT BEEN FOLLOWED BY ACTIONS WE NEED A WE NEED A BRIDGE BETWEEN RESEARCH AND HEALTH PLANNING A “NEW “ RESEARCH AREA WITH SPECIFIC METHODOLOGY A TRANSLATIONAL RESEARCH

TRANSLATIONAL RESEARCH 1. INFORMATION: set indicators, find data sources, establish cancer registries, collect / improve/ standardise data 2. ANALYSIS: analyse data, compare data, find relations, find major deficiencies 3. ACTION: design, validate and finance initiatives to reduce cancer disparities These phases are part of an iterative process Our goal is to constantly test the efficacy of the health intervention

We need data comparison: MAP OF EUROCHIP

INFORMATION: EUROCHIP LIST FOR PRIMARY PREVENTION Consumption of fruit and vegetables Consumption of alcohol Prevalence of tobacco consumption Population-based distribution of Body Mass Index Attitude to physical activity Exposure to sun radiation Occupational exposure to carcinogens

ANALYSIS: AVERAGE AMOUNT OF FRUIT AND VEGETABLES (KG) AVAILABLE PER PERSON PER YEAR Source: WHO, Health For All, 2004

INCIDENCE AND MORTALITY ESTIMATES ALL CANCERS COMBINED – 0-84 YRS – MEN North - Lombardy – MILAN South - Campania – NAPLES Standardized incidence rate (European standard) Standardized mortality rate (European standard) Source: Website “I Tumori in Italia” PRIMARY PREVENTION

AGE STANDARDISED - TOTAL PREVALENCE, -INCIDENCE, AND -SURVIVAL ALL CANCERS COMBINED, M + W, 1992 The area of the disk is proportional to the 5-year relative survival PREVENTION AIMS TO REDUCE INCIDENCE TREATMENT ACTS TO INCREASE PREVALENCE Source: Micheli et al Annals of Oncology, 2002

INFORMATION PHASE: EUROCHIP LIST FOR EARLY DETECTION Organised screening coverage % of women underwent a mammography % of women underwent a mammography % of women underwent a cervical cytology % of women underwent a cervical cytology exam exam % of persons underwent a colorectal cancer % of persons underwent a colorectal cancer screening test screening test

UTERUS CANCER STANDARDIZED MORTALITY RATE AGE: 20 – 44 (IN THESE AGES MOSTLY CERVICAL CANCER) European standard per 100,000 PHASE OF ANALYSIS

TRANSLATIONAL RESEARCH TRANSLATIONAL RESEARCH

The area of the disk is proportional to the Total National Health Expenditure ($ PPP) in the country $ PPP: Purchasing Power Parity, per capita (US $) Sources: Micheli A et al, Annals of Oncology, 2003 GROSS DOMESTIC PRODUCT (1997) AND 5-YEAR- AGE- AND CANCER SITE- ADJUSTED RELATIVE SURVIVAL (WOMEN)

Cancer control strategy Bridge between research and public health Guarantee health access & modify research strategy International co-operation Fight against health inequalities