The$European$support$for$improvement$and$early$ - - PowerPoint PPT Presentation

The$European$support$for$improvement$and$early$ detec6on$of$cancer$in$the$Caspian$region$ $$ $$Marco$Rosselli$Del$Turco$(Italy)$ $ Caspian$Region$Programme$Coordinator $ $

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UICC$–$World$Cancer$Congress$2012$ $ ESO7EASO$SESSION$$

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“An$European$support$to$Eurasia$and$Arab$World$$ to$improve$the$access$to$care”$

Wednesday$29$August$2012$7$Montreal$(Canada)$

THE$CASPIAN$REGION$PROGRAMME$

• Launched$in$2008$the$Caspian$Region$Programme$represents$

a$ new$ challenging$ ini6a6ve$ of$ the$ European$ School$ of$ Oncology$that$aims$to$create$a$specific$programme$for$those$ countries$ that$ are$ between$ Europe$ and$ Asia,$ in$ par6cular,$ Kazakhstan$.$

• The$main$aim$is$to$focus$and$to$organise$teaching$educa6onal$

ac6vi6es$on$one$type$of$cancer$which$is$considered$a$priority$ issue$for$the$popula6on$of$each$country.$$

$$ $ $$$$$$KAZAKHSTAN$NaSonal$Screening$Programme$ $$ $ $$

• Breast$cancer$and$coloNrectal$screening$has$been$chosen$as$a$

priority$issue$for$Kazakhstan.$ $

• In$2008$we$were$invited$by$the$Na6onal$Cancer$Ins6tute$

(Prof.$Arzykulov)$,$through$Sanofi$Oncology,$to$coNoperate$for$ the$improvement$of$quality$of$$screening$and$treatment$of$ breast$cancer$in$Kazakhstan.$ $

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The$main$ques6ons$are:$ $

• $Is$breast$cancer$screening$an$oncological$$priority$in$kazakhstan?$

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• $The$$improvement$of$quality$of$breast$cancer$screening$would$have$

$$$a$posi6ve$impact$also$on$breast$cancer$care?$ $

• $How$can$ESO$most$efficiently$support$the$Na6onal$Kazakhstan$

$$$health$system$in$this$field?$

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The$main$ques6ons$were:$ $

• $Is$breast$cancer$screening$an$oncological$$priority$in$kazakhstan?$

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• $The$$improvement$of$quality$of$breast$cancer$screening$would$have$

$$$a$posi6ve$impact$also$on$breast$cancer$care?$ $

• $How$can$ESO$most$efficiently$support$the$Na6onal$Kazakhstan$

$$$health$system$in$this$field?$

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Kazakhstan 36,4 Canada 83,2 GLOBOCAN 2008

Breast$all$ages,$wNage$standardised$ incidence$$

Breast$all$ages,$wNage$standardised$ mortality$ $ $

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Canada 15,6 Kazhkhstan 19,7 GLOBOCAN 2008 Georgia 19,7

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The$main$ques6ons$were:$ $

• $Is$breast$cancer$screening$an$oncological$$priority$in$kazakhstan?$

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• $World$–$age$adjusted$standardized$Mortality$rate$for$breast$cancer$

$$$in$Kazhakhstan$is$almost$the$half$$of$incidence$rate$$(19,7$vs$37,4),$ $$$whilst$in$North$N$Western$countries$as$Canada$is$about$one$fi`h$(15,6$vs$83,2)$ $

• $Although$popula6on$data$may$be$not$completely$exact$because$of$poor$$quality$

$$of$na6onal$cancer$registra6on,$a$low$5$–years$survival$is$expected$ $$(50N60$%$compared$to$80N90%$of$western$countries)$ $

• $The$impact$of$breast$cancer$screening$could$be$very$high$by$reducing$the$

$$$propor6on$of$advanced$cancers$ $ $ $$

From

No screening Estimated Screening Observed Estimated

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The$main$ques6ons$were:$ $

• $Is$breast$cancer$screening$an$oncological$$priority$in$kazakhstan?$

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• $The$$improvement$of$quality$of$breast$cancer$screening$would$have$

$$$a$posiSve$impact$also$on$breast$cancer$care?$ $

• $How$can$ESO$most$efficiently$support$the$Na6onal$Kazakhstan$

$$$health$system$in$this$field?$

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24 284 20 021 58 730 11 597 16 512 27 014 45 856 27 236 13 009 7 497 55 899 13 581 20 113 42 612 11 660 48 241 10000 20000 30000 40000 50000 60000 70000 Акмолинская Актюбинская Алматинская Атырауская ЗКО Жамбылская Карагандинская Костанайская Кызылординская Мангистауская ЮКО Павлодарская СКО ВКО г.Астана г.Алматы

Fig.$1.$Distribu6on$of$the$women$examined$during$the$mammographic$$ screening$by$regions$for$2011$(form:$KZ$na6onal$report$2011)$

Kz National breast cancer screening is covering All female population 50-59 ys. (443,862 w/y) (estimated attendance 70-80%)

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During$our$coNopera6on,$we$visited$different$regions$in$Kazakhstan$$ (Astana,$Almaty$and$Shymkent)$and,$in$general,$we$no6ced$ $

• $a$low$quality$of$mammography$

$$$N$equipments$and$technical$assistance$ $$$N$professional$training$and$clinical$skill$$ $$$$

• $a$low$level$of$interdisciplinarity$

$$$N$low$level$of$coNopera6on$betweeen$radiologists,$surgeons$ $$$$$$and$pathologists$ $$$N$low$level$of$preNopera6ve$diagnosis$

• Lack$of$reference$guidelines$

50 years – no symptoms– PE: Negative

2756363

Ultrasound-guided core-needle biopsy of the breast

1. EPIDEMIOLOGY 2. PHYSICO-TECHN. (Digital MX incl.)

• 3. RADIOGRAPHY
• 4. RADIOLOGY
• 5. DIAGNOSIS (Multid.)
• 6. PATHOLOGY
• 7. SURGERY
• 8. DATA COLLECTION
• 9. BREAST UNIT
• 10. CERTIFICATION

(by EUSOMA)

• 11. COMMUNICATION

39 Performance Indicators

European Guidelines for Quality Assurance in Breast Cancer Screening

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The$main$ques6ons$were:$ $

• $Is$breast$cancer$screening$an$oncological$$priority$in$kazakhstan?$

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• $The$$improvement$of$quality$of$breast$cancer$screening$would$have$

$$$a$posi6ve$impact$also$on$breast$cancer$care?$ $

• $How$can$ESO$most$efficiently$support$the$NaSonal$Kazakhstan$

$$$health$system$in$this$field?$

The$Kazakhstan$Project$for$Quality$Assurance$in$ Breast$cancer$Screening $ $ Supported$by$the$European$School$of$Oncology $ $

$ ! To$approve$defined$Guidelines$$ ! $To$$Establish$a$Na6onal$Quality$Assurance$Reference$Centre$at$the$Kazakh$ Scien6fic$and$Research$Ins6tute$of$Oncology$and$Radiology$(KSRIOR)$ ! $To$establish$mul6disciplinary$groups$in$each$regional$oncology$hospital$in$ Kazakhstan$ ! $To$implement$a$comprehensive$mul6disciplinary$training$programme$

Not$just$lectures$and$seminars $ but$a$comprehensive$program! $ Agreed$Targets$

Breast$Cancer$Screening$Joint$Project$$ (and$CRC$screening$project$in$2011)$ $ $

Astana$Nov.$2008$(MRDT)N$Preliminary$mee6ng$and$$planning$ Almaty,$Nov.$2009$(DM,MRDT)$N$Training$Course$and$$Site$visit$$ London,$July$–$August$2010$N$Training$of$two$KZ$Radiologists$ $at$the$Breast$Screening$Unit$$(Rosalind$GivenNWilson)$ $Almaty,$Nov.$2010$DM,MRDT).$Conf.$and$live$surgery$session$ $ $Astana/Almaty$May$2011$(TW,$DM$and$MRDT)$ N$$Breast$and$CRC$screening$$ N$$Training$seminar$for$screening$$ $Pathologists,$Radiologists$and$Radiographers$ N$$Site$visit$to$screening$program$$ $ $

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CRC$screening$project$started$in$2011$

N Site$visit$to$the$units$implemen6ng$CRC$screening$$ N$$Mee6ng$and$lectures$in$Almaty$(November$2011)$ N $Prepara6on$of$Na6onal$Guidelines$for$CRC$Screening$ N $Visi6ng$professor$of$Epidemiology$(L.$G.)$to$Almaty$(July$2012)$ $$$to$improve$quality$of$data$collec6on$and$analysis$ N Training$$of$2$endoscopists$$in$Europe$(NL$or$UK)$in$2012$ N $Seminar$on$CRC$Screening$in$November$2012$ $

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Kazakhstan 36,4 Canada 38,1 GLOBOCAN 2008

ColoNrectum,$both$sexes,$all$ages,$wNage$standardised$ incidence$

ColoNrectum,$both$sexes,$all$ages,$wNage$standardised$ mortality$ $ $

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Kazakhstan 12,3 Canada 11,7 GLOBOCAN 2008

Future$PotenSal$OpportuniSes$in$the$area$

$Breast$Cancer$Screening$in$Georgia:$

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• $site$visit$in$Tbilisi,$9N11$October$2011$
• Seminar$in$Tbilisi$in$December$2011$for$radiologists$and$

radiographers$

• Training$for$2$weeks$of$a$Georgian$radiologist$at$the$

Florence$(I)$breast$cancer$screening$programme$(April$ 2012)$

• Training$for$2$weeks$of$a$Georgian$Physicist$at$the$LRCB$

(Na6onal$Reference$Center$of$The$Netherlands)$in$ Nijmegen$(2012)$

• New$seminars$planned$for$November$2012$

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THE$CASPIAN$REGION$PROGRAMME$

STRENGHTS:$

• Priori6es$are$chosen$by$the$na6onal$Ins6tu6ons$
• European$Guidelines$(to$be$translated$into$Russian$language)$
• $Many$centralised$European$screening$programmes$can$be$

$$$$$$good$training$centres$

• Large$interest$from$the$local$specialists$$

$ WEAKNESSES$

• $Long$6me$needed$to$achieve$results$(mortality$reduc6on)$
• Possible$ changes$ of$ referent$ persons:$ need$ for$ a$ strong$

na6onal$commitment.$

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Thank you for attention!