2023-07-12 19:20:28
“The Italian Pulmonary Screening Network (Risp) is functioning homogeneously. By the end of the year we will bring the results to the Ministry of Health both in terms of diagnosis and primary prevention of smoking cessation. We believe that there are elements to make a decision on the introduction of pulmonary screening in the Lea (Essential Levels of Assistance). Today, with a simple, harmless test that takes a few seconds, such as a low-dose spiral CT scan, we can demonstrate the overall damage caused by a heavy smoker and activate individual and targeted prevention on the level of damage. The analysis with artificial intelligence of coronary calcifications, of those who entered screening 15-20 years ago, has in fact made it possible to verify the risk of mortality in the following 12 years”. This was stated by Ugo Pastorino, director of the complex structure of thoracic surgery of the National Cancer Institute of Milan, today in a hearing in the Social Affairs Commission of the Chamber on the ‘European plan to fight cancer’.
”The English Health Service – recalls Pastorino – decided, two weeks ago, to allocate 250 million pounds to screen one million English people. Italy is in a very favorable and driving position at the European level to demonstrate that a choice of this type can also be made by EU countries. It is a choice – he adds – which shifts part of the resources from therapy, which absorbs 80% of the resources, towards prevention, which absorbs less than 5%, with a gain both in terms of quality of life and results, but also of cost reduction related to the treatment of advanced and metastatic cornic disease and oncology, as occurs in lung tumors”.
In recounting the Italian experience, Pastorino explains that “the Cancer Institute of Milan, in particular, has carried out studies which have shown that it is possible, not only to reduce mortality from lung cancer, but to do, with very low doses of radiation , based on individual risk, screening to define, for each person, the risk in the following 10 years. The INT studies – underlines Pastorino – have also demonstrated that using a natural drug, cytisine, 40-50% of chronic smokers who undergo screening can be made to stop smoking. There is therefore the possibility of global prevention. Thanks to artificial intelligence (AI) and the new programs applied to all the CAT scans performed in the previous twenty years – over 10,000 volunteers and more than 30,000 exams – we demonstrate that the CT scan of the chest can precisely quantify heart damage, from the measurement of coronary calcifications, and pulmonary calcifications, from the evaluation of the parts of the lung destroyed by emphysema. This – clarifies the expert – opens up enormous possibilities for prevention in all fields, not only because it is possible to measure the accumulated damage, help the patient and motivate him to stop smoking, but also due to the possibility of an early diagnosis of other pathologies that , together with lung cancer, are the leading cause of death in heavy smokers.”
The Risp was financed by the ministry “with a project that selected 18 centers on the national territory, in agreement with the State-Regions conference – recalls Pastorino – The screening started in October 2022 with the aim of examining 7,300 people in a year. We have set up the national database which allows people to register and choose 3 centres, from which they will be contacted. Today, in the national Risp database we have more than 16,000 volunteers, half of whom are eligible for screening. Almost 6 thousand of these – he details – have already been screened. We plan to reach the goal of 7,300 volunteers by September. We have therefore asked the ministry for further funding to achieve the goal and demonstrate that it is possible to screen for lung cancer with primary prevention at a national level. All Risp volunteers – recalls Pastorino – will in fact receive free cytisine to take advantage of an effective and non-toxic pharmacological treatment, together with early diagnosis, but also precise information on the global damage “.
All of this opens up a window of intervention “which allows the prevention program to be individualized not only for lung cancer, for which it is certainly effective – summarizes Pastorino – but also for the early diagnosis of other diseases linked to smoking. This is crucial for an aging population, where quality of life, not just its length, is paramount. Primary prevention programs that integrate risk factor reduction with an early diagnosis and treatment of chronic diseases – he concludes – can overcome many of the resistances we know there are towards screening”.
#Lung #screening #Lea #global #prevention