EUROCHIP-2 the action

1. Health Indicators for Monitoring Cancer in Europe EUROCHIP-2the action Public Health Program EUROPEAN COMMISSION: HEALTH & CONSUMER PROTECTION DIRECTORATE-GENERAL www.istitutotumori.mi.it/project/eurochip/homepage.htm

2. EUROCHIP-2 IS BASED ONTHE RESULTS OF EUROCHIP-1 EUROCHIP-1: a unique public health project, meetings of uniquely large international consensus on the necessary information describing cancer and measures against cancer Aims: to produce a list of Cancer Health Indicators to help develop European Health Data Bank to reduce inequalities in cancer control

3. PREVENTION(indicators in ECHI list are underlined) • Consumption of fruit and vegetables • Consumption of alcohol • Body Mass Index distribution in the population • Distribution of indicators on physical activity in • the population • Prevalence of tobacco consumption • Exposure to sun radiation • Prevalence of occupational exposure to • carcinogens (CAREX)

4. CARE & TREATMENT(suggestions for ECHI list) • % of radiation equipment on population • % of diagnostic Computed Axial Tomography • (CTS) in the population • % of patients receiving palliative radiotherapy • Delay of cancer treatment: pilot studies • Compliance with best oncology practice

5. SOCIAL AND MACRO-ECONOMIC DETERMINANTS(indicators in ECHI list are underlined) • Anti- tobacco regulations • Estimated cost for a cancer patient • Total Public Expenditure on Health • Gross Domestic Product

6. SCREENING(indicators in ECHI list are underlined) • Organised screening coverage • % of women who underwent a mammography • % of women who underwent a cervical cytology • examination • % of people who underwent a colorectal cancer • screening test

7. PIL (1997) e sopravvivenza per tumore a 5 anni dalla diagnosi 5-year- age- and cancer site- adjusted relative survival (women) L’area del disco è proporzionale alla spesa sanitaria nazionale ($ PPP) nel paese $ PPP: Parity Purchasing Power per capita (US $) Sources: OECD 2002 for GDP and TNEH; EUROCARE-3 for survival

8. Tumore al colon – Totale spesa sanitaria nazionale (m+f 1992) Fonti: EUROCARE-2; Cancer Survival in European Elderly Patients and its Health, Social and Economic Determinants

9. Tumore alla mammella – Totale spesa sanitaria nazionale (f 1992) Fonti: EUROCARE-2; Cancer Survival in European Elderly Patients and its Health, Social and Economic Determinants

10. Total public expenditure on health and cancer survival - Men 5-year- age- and cancer site- adjusted relative survival Men - Median values per tertile - 1997 (from Annals, modified, 2003) $PPP % I) Public health expend. < 920 27.3 II) 920 < Public health expend.< 1492 42.0 III) Public health expend.> 1492 44.8 I, Estonia, Poland, Slovakia, Slovenia, Czech Republic, and Spain II, Finland, UK, Italy, Netherlands, Austria, and Sweden III, France, Switzerland, Iceland, Denmark, Norway, and Germany

11. Total public expenditure on health and cancer survival - Women 5-year- age- and cancer site- adjusted relative survival Women - Median values per tertile - 1997 (from Annals, modified, 2003) $PPP % I) Public health expend. < 920 41.7 II) 920 < Public health expend.< 1492 53.0 III) Public health expend.> 1492 54.2 I, Estonia, Poland, Slovakia, Slovenia, Czech Republic, and Spain II, Finland, UK, Italy, Netherlands, Austria, and Sweden III, France, Switzerland, Iceland, Denmark, Norway, and Germany

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

13. EUROCHIP-2: a European team-work for action and a bridge between research and health authorities

14. EUROCHIP-2 What’s needed? a) To liase with cancer data sources b) To encourage the set-up of data collection in areas where information is unavailable c) To check data quality and promote standardisation d) To develop a European health data bank

15. EUROCHIP-2 What must be done? a) Analysis of indicators’ behaviour b) Identification of deficiencies and differences in Europe taking into account health politics IN ORDER TO Support actions to reduce inequalities in cancer control

16. whoby? under which umbrella? through which phases?- The EUROCHIP-1 Network- The European Imprimatur - A Process Approach EUROCHIP-2

17. EUROCHIP-2: PROCESS APPROACH Ex. of health indicator: Breast cancer screening population coverage

18. EUROCHIP-2 : PROCESS APPROACH Example of health indicator: Computed Tomography Scanners

19. Comparison of the indicators in Finland and Denmark

20. EUROCHIP-2 Also takes into account the relation between cancer and other chronic diseases

21. Last 30 yrs Improvement in CVD and cancer treatment Life expectancy increased Number of cancer cases is increasing Present Inflation of prevalent cases Next future NEEDS: Actions in primary prevention Short term: assistance, palliative care, and hospices In 10 yrs Long term: reduction of cases

22. Health facilities required to manage a wide range of chronic and degenerative diseases are similar so that resources and in particular information resources can be shared Smoking Hospices Home assistance Diet Alcohol Palliative care BMI …. Rehabilitation

23. CANCER REGISTRATION & EPIDEMIOLOGY • Population covered by cancer registry • Incidence rates, trends and projections • Survival rates, trends and projections • Prevalence prop., trends and projections • Mortality rates, trends, projections and • person-years life lost due to cancer • Stage at diagnosis: % of cases with early • diagnosis and % who underwent a metastatic test

24. CANCER REGISTRIES:AN IMPORTANT ROLE • High qualified population based information • Permanent organisation • Public health-oriented