1. Work Package 6 Screening and Early Detection
European Partnership for Action Against Cancer
SC Meeting, Brussels 8.December 2010
Work Package 6 Screening and Early Detection
Package Leader: Ahti Anttila, Finnish Cancer Registry, Helsinki
Package Co-leader, Focal point & Technical Support: Dr Lawrence von Karsa
& Maria Fernan, IARC, Lyon
Associated Partners (7):
FCR / FCS: Finnish Cancer Registry / Finnish Cancer Society
NEN: Netherlands Standards Organization
CSISP: Centro Superior de Investigación en Salud Pública, Valencia
VAZG: Flemish Agency on Care and Health
SEF: NHS Sefton
AOSGB&CPO: San Giovanni Battista University Hospital of Turin CPO
IOL: Institute of Oncology, Ljubljana

2. WP6 Collaborating partners (37)
WHO: World Health Organization HQ
WHO: World Health Organization EURO, Denmark
IARC: International Agency for Research on Cancer
German National Association of Statutory Health Insurance Physicians, Germany
EUGF: United European Gastroenterology Federation, Ireland
VWS: Netherlands Ministry of Health, Welfare and Sport / RIVM, the Netherlands
ESPEN: European Society of Clinical Nutrition and Metabolism, United Kingdom
English Department of Health, United Kingdom
National Cancer Screening Service, Ireland (CEO), Ireland
Spanish Cancer Screening Network , Spain
Servei d’Avaluació i Epidemiologia Clínica, Spain
Public Association for Healthy People, Hungary
Malta National Breast Screening Centre (Ministry of Health, the Elderly and Community Care), Malta
Malta Breast Screening Centre, (Ministry of Health, the Elderly and Community Care), Malta
LRCB University of Neijmegen, the Netherlands
CANEPID: Division of Epidemiology & Cancer Prevention, Cancer Center & Institute of Oncology, Poland
Institutul Oncologic "I.Chiricuta" , Romania
Karolinska University Hospital, Stockholm Cancer Screening Program, Sweden
University of Oxford, United Kingdom
EDMA: European Diagnostic Manufacturers Association, Belgium
ELPA: European Liver Patients Association, Belgium
ECCO: European Cancer Organization, Belgium
ECL: European Cancer Leagues, Belgiu,
INCa: Institut National du Cancer, France
Aprémas (Coordinating Center for Cancer Screening), France
European Institute of Women's Health, Ireland
Europa Uomo, Italy
Instituto Tumori, Milan, Italy
Ministry of Health, Italy
Cancerworld, European School of Oncology, Italy
Ministry of Health, Portugal
Institute of Oncology, Barcelona, Spain
Europacolon, United Kingdom
ECPC: European Cancer Patient Coalition, United Kingdom
Lynn's Bowel Cancer Movement, United Kingdom
Department of Diagnostic Radiology, University of Turku, Finland
National Health Information Centre, Slovakia

3. Rationale: cancer screening
Improved implementation of the Council Recommendation on Cancer Screening continuously needed; included capacity building, evidence-based implementation modalities, and monitoring and evaluation
To be made accessible to all citizens who may benefit

4. CERVICAL Cancer Screening Programme Implementation in the EU
Estimated targeted proportion of year-old women in the EU by programme type and implementation status of Member States in 2007
2% Excluded
<1% no prog.
Population-based
Non population-based nationwide
47%
41 nationwide 7 regional
22%
29%
Rollout
complete
Rollout ongoing
20% Nationwide
Planning / Piloting
7% Nationwide
Regional 2%
Karsa et al., 2008

5. Estimated number of Persons attending Breast, Cervical and CRC Screening Programmes in the EU by Target Cancer and Programme Type in 2007
Estimates corrected for programmes in rollout phase and for missing data in Austria, Latvia, Greece, and Slovak Republic (all programmes) and in Denmark, France and Spain for cervical screening; and in Bulgaria for CRC screening.
Karsa et al., 2008

6. Rationale: early detection
Further added value will be created by promoting synergy between cancer screening and other areas of early detection
Health checks and periodic health examinations can range from early diagnosis to life style and primary prevention; dealing also with many other chronic diseases and health risks than cancer
For many of the health checks, the evidence base is lacking; and many other long established quality criteria for screening are not met aspects pertaining to early detection and prevention of cancer

7. Work Package 6 Screening and Early Detection
The main aims
Improving screening programme implementation
Reducing inequalities in screening
Regional workshops
Exchange of experience and initial consensus on quality criteria for health checks

8. ESSM (A.Anttila, FCR/FCS) (1)
Planning and initiation of a network of European Schools of Screening Management (ESSM) dedicated to capacity building for implementation and improvement of population-based cancer screening programmes
A two-week course curriculum will be developed by experts from key universities and research institutes and from internationally recognized centres of excellence in primary and secondary prevention of cancer. The course will be piloted in 2012

9. ESSM (FCR/FCS) (2)
The planning within the ESSM process include a full audit of one regional or national cervical cancer screening programme
The course will be piloted by training at least 15 competitively selected participants from national and regional screening management units. A criterium of selection will be the likelihood that the participant will constructively work on implementation or improvement of cancer screening programmes in the next few years
This, along with piloting of population-based programmes and with networking in order to develop certification in the framework within the ECN, will promote sustainability of the results

10. Inequalities (R.Peiro & D.Salas, CSISP, Valencia)
The literature of inequalities in participation and compliance in screening programmes will be reviewed
A survey addressed to the national or regional screening managers will focus on two main dimensions: collection of data suitable to describing and analyzing the existence of inequalities related to related to screening compliance and what kind of interventions have developed to reduce inequalities

11. Regions (S.Wallyn, VAZG; C.White, SEF; EUREGHA)
To support regions seeking to implement or improve cancer screening programmes as recommended by the Council of the EU, workshops will be held in the UK, Belgium and Italy
The workshops will bring screening experts across the EU together with regional stakeholders and responsible authorities. The focus will be on best practices, raising awareness and the obstacles to implementation

12. Quality criteria for health checks (M.Bijlsma, NEN, The Netherlands)
For the health checks, the experience emerged in the Netherlands in developing quality criteria for health checks will be exchanged with other member states and initial consensus on pan-European quality criteria for health checks will be developed
This aims to develop a coherent strategy to improve and maintain quality of such services - without recommending premature actions which, for lack of evidence, may be counterproductive

13. Further collaborations
The WP will establish links with the European Science Advisory Network for Health, European Network for Health Technology Assessment, and with the European Network on Cancer Screening and Prevention Programmes and will create new platforms for collaborations

14. About the activities and deliverables
Meetings, audio/teleconferences and networking among partners, collaborating partners, stakeholders, ministries and other authorities, and experts
Pilot the first European course on Screening Management
Seven reports/surveys [D04-D13]

15. Planned activities in the first year…
Kick-off teleconferences and meetings, establishing the teams, recruit experts, start networking
ESSM: start activities of the School with the partners
Plan, perform and report of a full audit of one regional screening programme
Plan the first international course
Inequalities: Accomplish the literature review
Regions: First regional workshop
Quality criteria for health checks
A report on the Dutch criteria
Survey on the European level