Cancer patients can no longer wait, there is not only Covid. Cancer became an emergency in an emergency. Italy must react immediately with a national cancer plan in line with the European plan to fight cancer, to protect the lives of people with cancer. To draw the attention of the institutions, worried about the many delays already reported by patients and oncologists, Francesco De Lorenzo, president of the Italian Federation of Voluntary Associations in Oncology (Favo) which represents and brings together 550 realities active throughout the national territory. The Covid-19 pandemic is seriously endangering the lives of people affected by cancer and patient representatives are appealing to the attention of the Government and the Regions, so that the levels of care prior to the spread of the epidemic be restored with extreme urgency in the oncology field. The numbers that emerge from the IQVIA survey take a clear, gloomy picture: during 2020, Covid has had a significant impact on the number of new diagnoses and treatments, as well as on requests for specialist visits and examinations, with 613 thousand fewer new diagnoses (-13%) and 35 thousand fewer new treatments (-10%), with a drastic drop in mailings to specialists (-31%, or as many as 2 million 230 thousand visits) and requests for exams (-23%, that is, 2 million 860 thousand). The pandemic has had strong negative repercussions on cancer treatment by interrupting prevention, treatment and follow-up actions, delaying diagnosis and vaccinations and affecting access to drugs and causing deaths, stresses De Lorenzo.
It is urgent to immediately reverse the course
According to a recent analysis of the activities carried out by AGENAS in times of pandemic, a decrease of about 30% of the three screenings for early diagnosis emerges in 2020 (that for cervical cancer -32.20%, mammography for breast -30 , 32% and Sof test for colorectal cancer -34.70%) and a decrease in the volumes of activity of surgery for cancer ranging from 20% to 30% (breast -22.05%, prostate -24, 02%, colon -32.64%, lung -18.25%, uterus -13.84%, melanoma -21.47%, thyroid -31.23% just to give examples). What do these numbers mean? Means that the apparent decrease in new oncological diagnoses will unfortunately result in an increase in patients whose cancer will be diagnosed late with the consequence that more invasive and heavy therapeutic interventions will be necessary and with less chance of cure and recovery – he replies Elisabetta Iannelli, general secretary Favo -. Not only that: we will have higher socio-health costs and human suffering and an increase in deaths from cancer as an indirect cause of Covid. a necessary and urgent U-turn, the response to the oncological emergency indirectly caused by the pandemic must arrive immediately.
Cancer patients and the fear of going to the hospital
The data collected also show that to date oncologists see far fewer patients than in the run-up to the pandemic: 30% less from April 2020 to February 2021, which means that on average around 25-30 fewer patients are seen per week. Not only for “clogging” of the system, but also for fear of the sick to go to hospital and contract Covid. A well-founded fear? The commitment of oncologists has not failed, considering the exceptional and dramatic conditions caused by the pandemic emergency, but this is not enough – says Iannelli -. Sick people have had and are afraid to go to places of care because they fear the risk of contracting the virus and this despite the fact that safe routes have been set up in cancer centers, covid-free, for cancer patients. It is necessary to increase the level of safety that must be guaranteed to cancer patients, among the most fragile people: the immediate use of vaccination, already implemented in many regions but not yet in all, differentiated and protected paths in all hospitals. Patients’ associations are asking for the right to an emergency plan to reduce waiting lists in cancer surgery.
The responses from politics
The cry of alarm raised by Favo to the Social Affairs Committee of the Chamber was first fully acknowledged by the Honorable Member Elena Carnevali (member XII Social Affairs Commission, Chamber of Deputies) and subsequently by the senator Paola Binetti (member 12 Hygiene and Health Commission, Senate of the Republic), with two resolutions approved unanimously in 20 days and with the favorable opinion of the Government. In mid-April 2021, the Senate approved a unitary agenda with which the Government was urgently asked to launch as soon as possible the new National Plan for Oncology and the Government, apologizing, undertook to do so by next June says De Lorenzo. An important step towards the implementation of the provisions of the resolutions, through a new National Cancer Plan which, in line with the European one, defines an overall project to be included in the Recovery Plan. The National Cancer Plan – clarifies Iannelli – will not simply be able to update the previous one (which actually dates back to 2011, then extended until 2016) also because it will be inspired by the European Plan presented on 4 February on the occasion of World Cancer Day and whose objective is to cope with the entire course of the disease being structured around four fundamental areas of intervention: 1) prevention; 2) early detection; 3) diagnosis and treatment; 4) quality of life of cancer patients and survivors of the disease.
National cancer plan: because it is needed urgently
The Cancer Plan is a crucial point for all those directly involved, from cancer patients to healthcare professionals. The Italian Plan will have to ensure a central direction to prevent avoidable tumors, guarantee early diagnosis, ensure equitable access to cancer treatments, strengthen infrastructures and services (with adequate funding) – concludes Iannelli -. necessary to develop digital health through the tools of telemedicine, teleconsultation, access and sharing of health data (medical record and electronic health file) and also to proceed with the actual implementation of the oncological medicine of proximity through the use and development of the territory (health houses, general practitioners and community nurses, in collaboration with cancer centers). The possibility of guaranteeing also passes from a National Cancer Plan access to innovative treatments and precision medicine and the planning of the regional oncological networks and the therapeutic and assistance diagnostic paths (PDTA) which have been talked about for some time as essential steps, but not yet fully implemented in Italy.
May 6, 2021 (change May 6, 2021 | 19:10)
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