Pressing on the European Council to “optimize lung cancer screening in Europe by proposing the necessary measures, based on scientific evidence”. This is the request of the Challenge Cancer intergroup, which met in recent days under the chairmanship of MEP Cristian-Silviu Busoi, president of the Commission for Industry, Research and Energy, in collaboration with the European Cancer Patient Coalition (ecpc). At the center of the discussion, behind closed doors, was the Council Recommendation on cancer screening which proposes a new approach to help Member States increase the diffusion of cancer screening, published by the European Commission on 20 September.
“The reason why, as the European Cancer Patient Coalition, we felt it necessary to organize a moment of discussion with the MEPs – explains Franco De Lorenzo, president of the ECPC – stems from the fact that the draft discussed by the working groups of the Council of European Ministers states that the evidence in favor of low-dose CT (LDTC) is only preliminary, when instead there are long-term results of three randomized studies conducted in the USA, Europe and Italy have shown that an intervention for the early diagnosis of lung cancer with LDTC in heavy smokers it can achieve a reduction in mortality from lung cancer of between 20% and 39%, depending on the duration of the intervention.In particular, it has been demonstrated – he underlines – that this intervention can significantly reduce mortality from lung cancer in 8-26% for men and 26-61% for women”.
According to the European Cancer Patient Coalition, “ignoring the already existing scientific evidence on the benefits of early screening and leaving it to Member States alone to assess the need for cancer screening at national level, according to their resources and capacities, leads to the failure to implement the recommendations of the European Cancer Plan on cancer screening and will further exacerbate inequalities in access to cancer care in Europe”. Busoi therefore sent a letter to the EU Council and the Commission with concrete recommendations, in view of the final proposal to be adopted at the Council meeting on employment, social policy, health and consumer affairs (Epsco) on December 9. The declaration was signed by 50 MEPs.
The need for a change of pace on lung cancer screening was also underlined by the 2 experts invited to the Challenge Cancer intergroup meeting, Ugo Pastorino, director of thoracic surgery at the Irccs Foundation – National Cancer Institute of Milan, and Giorgio Vittorio Scagliotti, professor of Medical Oncology at the University of Turin, who shed light on the medical aspects of the Council Recommendation and its impact.
In particular, the experts point out, the revised text does not give due importance to low-dose computed tomography for lung cancer screening and, in general, it is not sufficiently clear on the need to implement lung cancer screening gradually, including, among other factors, the eligibility criteria, and thus limiting its scope. “Low-dose CT represents a promising life-saving strategy – explains Scagliotti – but to date it does not fall within clinical practice and secondary prevention programs reimbursed by the NHS. It is estimated that the candidate population for lung screening with low-dose CT is included between 600,000 and 800,000 citizens in our country. It is necessary to promote a cultural change in public opinion, decision-makers and institutions, making them aware of the need to implement screening for this pathology”.
“Lung cancer screening – Pastorino remarks – can prevent over 5,000 deaths every year in Italy. With low-dose computed tomography of the chest it is possible to increase the number of early stage diagnoses from the current 25% up to 60%. %. Low-dose CT is therefore the most suitable tool: it is effective in identifying small lesions, is easy and quick to perform (30 seconds), is non-invasive and does not require contrast medium. , it is possible to identify very small tumors, treatable with minimally invasive and personalized surgery, ensuring the patient a rapid functional recovery and an early discharge”.
MEPs proposed concrete measures to ensure a reduction in the burden of lung cancer: include a separate section on lung cancer screening, with an explicit acknowledgment of the strong evidence base; clarify the proposed ‘step-by-step’ approach to lung cancer screening implementation, ensuring that evidence and lessons learned from lung cancer screening implementation activities across Europe are exploited for new programmes; include a more ambitious review period for lung cancer screening than 3 years prior to adoption, and every 4 years thereafter, as existing evidence for lung cancer screening and implementation evidence of programs and pilot projects should support faster implementation.