Dr Andrea Micheli Descriptive Epidemiology and Health Planning Unit Fondazione IRCCS “Istituto Nazionale dei Tumori” Milan Public Health Programme EUROPEAN COMMISSION: HEALTH & CONSUMER PROTECTION DIRECTORATE-GENERAL EUROCHIP-1EUROCHIP-2EUROCHIP-3 EUROCHIP: EUROpean Cancer Health Indicator Project

-1a list of Cancer Health Indicators -2CANCER CONTROL actions in 24 European countries; the “pillars”: care & treatment indicators, cervical screening, cancer registration -3further action on the pillars of EUROCHIP-2; discussion on cancer rehabilitation and costs EUROCHIP works in Consensus Conferences involving cancer experts of EU institutes, organisations and networks EUROCHIP EUROCHIP EUROCHIP

EUROCHIP-1..3 Cancer is an important element of our societies Why? To fight inequalities What? Translational research project How? Economy of scale: EU network of willing people permanent consensus conference permanent consensus conferenceactions

INDICATOR A INDICATOR B INDICATOR C. INDICATOR Z INDICATOR A INDICATOR B INDICATOR C. INDICATOR Z INFORMATION ANALYSIS ACTIONS

EUROCHIP-2 ACTION PLAN COUNTRY 1COUNTRY 2COUNTRY 3 COUNTRY 30 ACTION1ACTION1 ACTION2ACTION2 ACTION3ACTION3 ACTION3ACTION3 ACTION4ACTION4 ACTION4ACTION4 ACTION5ACTION5 ACTION6ACTION6 ACTION6ACTION6 Care & treatment EUROCHIP Pilot studies Early diagnosis Against avoidable deaths Country’s specific actions SOLIDARIETY-BASED EUROPEAN PUBLIC HEALTH ACTIONS COMMON ACTIONS Epidemiology Lack of cancer information EDUCATIONAL ACTIVITY

A project based on solidarity against inequalities: the EUROCHIP-2 MAP

1.EUROCHIP-2 Pilot Studies: feasibility studies in cancer registries to study the possibility to collect three indicators at population level: “Stage at diagnosis”, “Delay of cancer treatment” and “Compliance with guidelines” for breast and colorectal cancers 2.Early diagnosis of cervical cancer in 5 Eastern European countries (Presentations during this meeting) 3.Lack of cancer information: Activities in two countries without cancer registration Recommendations to the EC Network of Competent Authorities in support of cancer registration in Europe EUROCHIP-2 PILLARS

Three indicators: “Stage at diagnosis”, “Delay of cancer treatment” and “Compliance with guidelines” EUROCHIP-2 Pilot Studies are feasibility studies in cancer registries of 10 countries They are performed to address the following questions: is it possible to collect these indicators at population level? is the information already available? from which sources can (or could) the data be obtained? EUROCHIP pilot studies refer to breast and colorectal cancer AIM: TO IMPROVE THE CANCER INFORMATION SYSTEM PILLAR 1

EASIER COLLECTION MORE ROUTINE COLLECTION STAGE AT DIAGNOSIS: TYPE OF COLLECTION BREAST CANCER PILLAR 1

Death rate per 100,000 Source: WHO UTERUS CANCER MORTALITY TRENDS WOMEN AGED 20 – 44 (MOSTLY CANCER OF THE CERVIX) Standardized death rates (European standard) PILLAR 2

BULGARIA: assessment surveys on information level standard of cytological labs ROMANIA: assessment study shows high difficulties to implement screening in the near future In 2007 legislative changes were initiated on cervical screening LATVIA Workgroup of Latvian oncologists, gynaecologists, GP, stakeholders and health planners 2 informative documents were submitted to the MoH Screening expected to start in 2009 ESTONIA: cervical screening limits are low adherence, no screening registry, lack of reference laboratory LITHUANIA: a study was organized to evaluate results of the centralized invitation system in one municipality in Lithuania. It provides evidence and benefits of this system PILLAR 2 AIM: TO AVOID AVOIDABLE DEATHS LATVIA Workgroup of Latvian oncologists, gynaecologists, GP, stakeholders and health planners 2 informative documents were submitted to the MoH Screening expected to start in 2009 LITHUANIA: a study was organized to evaluate results of the centralized invitation system in one municipality in Lithuania. It provides evidence and benefits of this system

PILLAR 3 AIM: TO IMPROVE THE CANCER REGISTRATION  Activities in two countries without cancer registration: Greece and Luxembourg  Recommendations to the Network of Competent Authorities in support of cancer registration in Europe  Educational activity: EUROCHIP-2 sponsored in 2006 the participation of 9 researchers from Eastern European countries to the course “Cancer survival: principles, methods and applications” (London, 3-7 April 2006)

EUROCHIP-2 PUBLICATIONS Chapter on “Cancer Information” for Slovenian Presidency cancer book Chapter on cancer for the European Commission Report on Major and Chronic Diseases Chapter on cancer for the European Global Report on Health (EUGLOREH) Article on macro-socioeconomic variables relation with cancer survival (EJPH) Article on life tables for world-wide comparison of relative survival for cancer (Tumori) Other articles across the EU during the project period for country’s specific actions

EUROCHIP ROLE AFTER THE SECOND ROUND One of the main references for the European Commission on cancer Established contacts in the majority of MSs. Performed 27 actions in 24 countries Contacts with MoHs or bodies strictly connected with health ministries Connections with main international networks on cancer control Link with MEP’s (June 07 Meeting at European Parliament) Link with Portoguese and Slovenian Presidency Steering Committee Member of the 2nd and 3rd International Cancer Control Congress