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EUROCHIP - EUROpean Cancer Health Indicators Project

A fight against disequalities in managing cancer

HMP: Health Monitoring Programme

Andrea Micheli1, Paolo Baili1, Carmen Martinez2, Riccardo Capocaccia3, Jan Willem Coebergh4, Arduino Verdecchia3, Franco Berrino1, Eugenio Mugno1, Camilla Amati1, Michel Coleman5

1 Unit of Epidemiology – Istituto Nazionale per la Cura e lo Studio dei Tumori – Milan (I) – 2 Granada Cancer Registry – Escuela Andaluza de Salud Publica – Granada (E), 3 Laboratory of Epidemiology and Biostatistics – Istituto Superiore di Sanità – Rome (I),

4 Comprehnsive Cancer Centre South Eindhoven Cancer Registry – Eindhoven (NL), 5 Cancer and Public Health Unit – London School of Hygiene & Tropical Medicine – London (UK)

THE PROJECT

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

EUROCHIP AIMS

BACKGROUND

CANCER SITES TO BE CONSIDERED FOR THE LIST

Produce a list of health indicators describing cancer in Europe in order for:

a) helping the development of European Health Information System

b) reducing inequalities in cancer control

c) promoting action in the fight against cancer

Each indicator was discussed by groups of experts of different expertise in prevention, cancer registration, screening, treatment and health economy, who described it by its general presentation, operational definition, meaning, possible use, caveat, modalities of classification, possible source, standardisation and validity.

EUROCHIP provided a list of cancer malignancies taken as proxy of different phases of cancer surveillance :

TERTILES:

I: Estonia, Poland, Slovenia,

Slovakia, and Spain;

II: UK, Finland, Netherland,

Sweden, Italy, and Austria;

III: Iceland, Denmark, France,

Germany, and Switzerland

METHODS

All cancers combined without non melanoma skin cancers

Cancers of:lung, breast, colorectal, prostate, stomach,head and neck, larynx, oropharynx, melanoma, kaposi, mesothelioma, testis, haematopoietic malignancies, childhood tumors, cervix

INTELLECTUAL WORK INVOLVING 130 CANCER SPECIALISTS

OF EU MEMBERS, CANCER NETWORKS, INSTITUTES AND

ORGANISATIONS

LIST OF INDICATORS AND THEIR AVAILABILITY: COMPARISON BETWEEN EUROPE AND US

CONCLUSIONS AND FUTURE

EUROCHIP achieved to produce a list of indicators and to gather guidelines and for the European health information system on cancer.

Final goal of EUROCHIP was to find information able to describe differences and also to promote action that would reduce inequalities in managing cancer. This last is the core of the ongoing EUROCHIP-2 project.

It will be really useful to compare European data with American ones. Today this is possible for some European countries and for traditional epidemiological measures, but it is important to highlight that many indicators proposed by EUROCHIP are already available in US.

To reduce inequalities across Europe, some countries have to prioritise action on prevention, others on care, others on surveillance. However, it is vital for each countries’ success in the fight against cancer, that the trans-national European nature of the study is maintained at all levels of data collection, data analysis, problem evaluation, and action.

EUROCHIP-2 will add value to each countries actions by stimulating data comparison (also with US data) and providing a unified International/European imprimatur to cancer action.

EUROCHIP-2 will try to:

  • SET UP DATA COLLECTION
  • ANALYSE THE BEHAVIOUR OF VARIOUS INDICATORS IN RELATION TO THEIR UTILITY
  • IDENTIFY DEFICIENCIES IN EUROPEAN HEALTH SYSTEMS
  • ENCOURAGE ACTIONS TO REDUCE INADEQUANCIES IN CANCER CONTROL

A: Availability for large part of Europe;

B:US Department of Health and Human Services, Public Health Service, NIH, National Cancer Institute. CANCER PROGRESS REPORT 2001;

C: Surveillance Research Program, National Cancer Institute. SEER*Stat software

Version 5.0.17

(www.seer.cancer.gov/seerstat)

*: From OECD Health Data 2002