Primary prevention also represents a problem, due to the marked worsening of lifestyles and the absence of information, education and awareness programs among the population
On February 4th we all celebrate the World Cancer Day, established in 2000 by the Union for International Cancer Control (UICC). The main objective of the Day is to support the contents of the 2008 World Cancer Declaration. It is an appeal to all Governments to promote initiatives that go in the direction of ever greater equity towards all citizens with regards to healthever greater accessibility of services, a reduction in disparities in the incidence and mortality of cancer (around 10 million per year worldwide) and in care for these diseases.
The most difficult tumors
What is the current situation in our country? We record around 400 thousand new cases annually, with around 175 thousand deaths (slightly but steadily decreasing in recent years)with some partial successes for avoided deaths in cancers lung in men (smoking cessation), cancers of the breast (early diagnosis and better treatments, both in the initial phase and in the advanced stages) e colorectal (as for the breast). But very critical situations still remain, such as those relating to lung cancer in women (increased cigarette smoking), del melanoma (sun exposure but recently there have been notable advances thanks to biological treatments and immunotherapy), in pancreatic cancer (really difficult and difficult tumor, both in terms of prevention and treatment).
Primary and secondary prevention
Primary prevention in our country represents a real problem, however the net worsening of lifestyles and for the absence of information, education and awareness programs for the population (especially young people) towards these themes. And to say that around 40% of cancers could be avoided with primary prevention and consequently could be greatly reduced the 20 billion euros that are spent annually to treat cancer patients. Secondary prevention (screenings) equally neglected, with a membership of 35-40% in the national average for the year 2022 and with the Southern Regions presenting data of 12-30%. While Europe (with Europe’s Beating Cancer Plan) asks all member countries to reach, by 2025, 90% participation of the target population for all screenings.
Progress in treatment
Progress in the treatment of tumors has been enormous in recent years: various research groups and brilliant experimental and clinical researchers in our country have contributed to them. Think of the exceptional diffusion of the new ones biological drugsconsequent to genetic-molecular characterization of tumorsto theimmunotherapy with bispecific antibodies capable of acting simultaneously on multiple cellular sites, drug conjugated antibodies (Adc), which deliver the cytotoxic drug specifically to tumor cells, to the development of anti-PD1 drugs and their combination with mRNA anti-tumor vaccines, in studies involving numerous tumors. All these treatments have changed the natural history of many tumors and many patients. But the problems, quite a few, concern patient access to clinical trials after the delay accumulated in our country regarding the adaptation to the European Regulation on testing of 2014, with the establishment of the Clinical Trials Information System (Ctis), the single continental portal for trials.
Long lead times for new drugs
Another big problem represented by registration times of the Italian Medicines Agency (Aifa) after approval by the European Medicines Agency (419 days on average)to which is added in many cases the (very long) times required for the registration of new drugs in the regional therapeutic handbooks, a true outrage against Article 32 of the Constitution (The Republic protects health as a fundamental right of the individual and interest of the community ). We are thirteenth in Europe and last among Western European countries, regarding drug approval times. All these aspects require our commitment, which has never been lacking in recent years in terms of analysis and description of the critical issues as well as concrete proposals. But a great effort in listening, availability and action is necessary on the part of the institutions involved and we are certain that with the right attitude on everyone’s part, cancer patients in our country (but I would say all citizens) can be better protected and helped in the fight against this disease.
* President of the Confederation of Oncologists, Cardiologists and Hematologists (FOCE)
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February 4, 2024 (modified February 4, 2024 | 11:29)
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