EUROCHIP-ItaliaEUROCHIP-Italiainin

EUROCHIP-2EUROCHIP-2

Health Indicators for Monitoring Cancer in EuropeHealth Indicators for Monitoring Cancer in Europe

Public Health ProgramPublic Health ProgramEUROPEAN COMMISSION: HEALTH & CONSUMER PROTECTION DIRECTORATE-GENERALEUROPEAN COMMISSION: HEALTH & CONSUMER PROTECTION DIRECTORATE-GENERAL

Italian Health MinistryItalian Health Ministry

EUROCHIP-2 EUROCHIP-2 IS BASED ONIS BASED ON THE RESULTS OF EUROCHIP-1 THE RESULTS OF EUROCHIP-1

EUROCHIP-1: EUROCHIP-1: a public health project with a public health project with

meetings of large international consensus on the meetings of large international consensus on the necessary information necessary information

describing cancer and measures against cancerdescribing cancer and measures against cancer

Aims: Aims: to produce a list of Cancer Health Indicators to produce a list of Cancer Health Indicators to help develop European Health Data Bankto help develop European Health Data Bank

to reduce inequalities in cancer controlto reduce inequalities in cancer control

www.istitutotumori.mi.it/project/eurochip/homepage.htmwww.istitutotumori.mi.it/project/eurochip/homepage.htm

The area of the disk is proportional to the Total National Health Expenditure ($ PPP) in the country

$ PPP: Parity Purchasing Power per capita (US $) Sources: OECD 2002 for GDP and TNEH; EUROCARE-3 for survival

Gross Domestic Product (1997) and 5-year- age- and cancer site- adjusted relative survival (women)

Total Prevalence, All Cancer Total Prevalence, All Cancer m+f, 1992 m+f, 1992

Prevalence per 100 000

2239

1169

1339

1442

1759

1862

1867

2012

2098

2356

2388

2427

2565

2597

2778

3047

1867

2018

0 500 1000 1500 2000 2500 3000 3500

European registries

Polish registries

Estonia

Slovenia

Slovakia

Spanish registries

Finland

Dutch registry

English registries

Iceland

Scotland

French registries

Denmark

Austrian registry

Swiss registries

Italian registries

German registry

Swedish registry

Main Public HealthMain Public HealthStrategies in EuropeStrategies in Europe

• Wealthy areas: Primary Prevention, management of queues

• Less wealthy areas: Treatment and investment

• All: focus on the elderly

EUROCHIP-2EUROCHIP-2aa European European

team-work for action team-work for action

A link between research and A link between research and health authoritieshealth authorities

who by? under which umbrella? through which phases?

- The EUROCHIP-1 Network- The EUROCHIP-1 Network- The European Imprimatur - The European Imprimatur - A Process Approach- A Process Approach

EUROCHIP-2

What’s needed?

a) To liase with cancer data sourcescancer data sources

b) To encourage the set-up of data collection in areas where information areas where information is unavailableis unavailable

c) To check data quality and promotequality and promote standardisationstandardisation

d) To develop a European health data European health data bankbank

EUROCHIP-2

What must be done?

a) AnalysisAnalysis of indicators’ behaviour

b) Identification of deficienciesdeficiencies and differences in Europe taking into account health politics

EUROCHIP-2

IN ORDER TOIN ORDER TOSupport actionsactions to reduce inequalities in cancer control

Example of health indicator: Computed Tomography Scanners

EUROCHIP-2 : PROCESS APPROACHEUROCHIP-2 : PROCESS APPROACH

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Check ofsources

Data collection Datacomparison

Diffusion of CTS

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er o

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trie

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Computed Tomography Scanners and Computed Tomography Scanners and 5-year- age- and cancer site- adjusted relative survival (F)5-year- age- and cancer site- adjusted relative survival (F)

EUROCHIP - ItaliaEUROCHIP - ItaliaAn Italian project involving cancer registries, screening programmes, IRCCS (Hospitalization and Treatment Scientific Institute), to disseminate knowledge and to promote actions for:

• reducing the probability of becoming ill• increasing survival• sorveglianza sanitaria • better quality of life for patients• REDUCING INEQUALITIES

Home page - www.tumori.net

The study of inequalities: a critical topic of public health

Enables us to foresee what results can be achieved

through correct health polities

5-year-before diagnosis relative survival (%) 5-year-before diagnosis relative survival (%) age and cancer site-adjusted age and cancer site-adjusted

Italian Cancer Registries - EUROCARE-3, 1990-94Italian Cancer Registries - EUROCARE-3, 1990-94

TUTTI I TUMORI

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usa

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sari

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ova

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cana

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rara

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M F

Ragusa: M 33%, F 44%; Varese: M 39%, F 53%; Romagna: M 45%, F 58%Ragusa: M 33%, F 44%; Varese: M 39%, F 53%; Romagna: M 45%, F 58%

5-year-before diagnosis relative survival (%) 5-year-before diagnosis relative survival (%) Age -adjusted , Age -adjusted , Period TrendsPeriod Trends

Varese&Ragusa Cancer Registries EUROCARE, 1980-94Varese&Ragusa Cancer Registries EUROCARE, 1980-94

Goal Groups STEPS

Epidemiological estimates

a)Mortality, Incidence, Prevalence and Survival Estimates for a selection of Cancer sites and Italian Regions

b)Set-Up of Scientific Committee

Cancer Registries

a)Confrontation with International Datab)Link with other Information Systems of Epidemiology c)Coordination with AIRT website (in progress)

Risk Factorsa) Study of all Risk Factors-related literatureb)Assessment and resume of prevalent factors in Italy

Screening Programmes

a)information on Screening related-activityb)Relazione con reti italiane di screening (GISMA e GISCI)

Training and Information

a)Interactions with Systems of Information b)Regular Data Publication to Press

Southern Italya)Data Assessment for Italy and Southern Regionsb)Identifications of lacking regions

EUROCHIP - Italia (I Tumori in Italia)EUROCHIP - Italia (I Tumori in Italia)

0%

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90%

100%

TAC Spirale PET Mammografia

Nord

Centro

Sud e Isole

Source: Italian Oncology White Book, 2Source: Italian Oncology White Book, 2

Medical Oncology Unit Percentage with CTS, Medical Oncology Unit Percentage with CTS, PET and Mammography. Macroregional dataPET and Mammography. Macroregional data

Source: Italian Oncology White Book, 2Source: Italian Oncology White Book, 2

Medical Oncology Unit Percentage per facilitiesMedical Oncology Unit Percentage per facilitiesMacroregional DataMacroregional Data

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Cure palliative Terapia deldolore

Hospice Assistenzadomiciliare

Nord

Centro

Sud e Isole

Proposal Proposal for newfor newactionsactions

EUROCHIP - ItaliaEUROCHIP - Italia