A manifesto-appeal to “raise awareness among the population at risk and the Italian and European political class on the need to include lung cancer screening” with low-dose CT “among the essential screenings. It is not invasive, it is no longer expensive, and it should be accessible to all those who can benefit from it. “Giorgio Vittorio Scagliotti, director of the Division of Medical Oncology at the University of Turin, thus summarizes the message intended to be launched with the ‘Manifesto Italian PolmoniAmo ‘, presented today in Milan and created with the support of AstraZeneca.
A message addressed to multiple recipients, including the Italian Parliament, “which is called a civic duty: to facilitate all those initiatives which tend to allow access to methods of early diagnosis to ever wider sections of the population, eliminating existing barriers”. The manifesto was drawn up by the clinicians involved every day in the care of patients affected by lung cancer. “We call the national and regional institutions together with the scientific communities to a call to action – reads the text – in order to guarantee the right to access to screening for Italian citizens at high risk (by age and by tobacco exposure) to develop the lung cancer, through the inclusion of screening within the essential levels of assistance (Lea) in the same way as cervical, colorectal and breast cancer screening programs “.
“I think that, too on the eve of the Italian Cancer Planamong the objectives that are identified and with the resources that are also allocated through the National Recovery and Resilience Plan (Pnrr), we can address a targeted action so that lung screening becomes the patrimony of our Italian health policy “, says Elena Carnevali, member of the Social Affairs Commission of the Chamber. This neoplasm, observes Scagliotti who is scientific coordinator of ‘PolmoniAmo’ together with his colleague Ugo Pastorino, director of thoracic surgery of the Irccs National Cancer Institute (Int) in Milan, “so far it has received less attention than othersalso because of the social stigma, attributable to the history of smoking in the majority of patients. Low-dose CT scan represents a promising life-saving strategy, but to date it is not part of clinical practice and secondary prevention programs reimbursed by the national health service. It is estimated that the population eligible for lung screening, according to international guidelines, is between 600 thousand and 800 thousand Italians. With the manifesto we want to promote a cultural change “.
Furthermore, adds Scagliotti, “we want to build a new collaborative model, creating a path that offers tools and resources for the activation of secondary prevention programs throughout the territory, in particular involving family doctors. Anti-smoking centers must also be implemented. To achieve these goals they are needed funds, which can be recovered from the Pnrr“In the meantime, we look at the data that may arrive from the Italian lung screening network (Risp) in support of the importance of implementing this tool.
With the Sostegni-bis Decree Law, 2 million euros were disbursed for the two-year period 2021-2022 to support the first national experimental lung screening program. Thanks to the funding, the Ministry of Health and the Regions have established the Resp. “This is the first free early diagnosis program for lung cancer – explains Pastorino – It is aimed at people between the ages of 55 and 75, who have been consuming a pack of cigarettes a day for more than 30 years. Even the strong can participate. smokers who have quit less than 15 years. 19 centers with high multidisciplinary clinical competence are involved throughout the territory “. The potential of screeninghighlights the specialist, “extends beyond cancer prevention, allowing the early identification of other smoking-related diseases, such as chronic obstructive pulmonary disease and heart disease “. The low-dose CT scan” allows to calculate the degree of calcification of the coronary arteries, directly proportional to the risk of heart attack or coronary stenosis. A cardiovascular risk assessment can therefore also be obtained “.
“We must take advantage of all the progress accumulated in recent years, including the development of new technologies for automated CT analysis, which help to avoid problems such as false positives and unnecessary interventions or for diseases that would not lead to any damage. all start from the highest level of current knowledge and of course it will also help the ministry to understand in 2-3 years how effective screening is and decide if this can be a reimbursable procedure in high-risk subjects “.
“By 2022 – adds Carnevali – the European Commission will present a proposal to update the Council of Europe recommendation on cancer screening, precisely to ensure greater correspondence with the most recent scientific data. The possibility of applying non-targeted screening will be evaluated. only to breast, cervical and colorectal cancer, but also to prostate, lung and gastric cancer.The time could not be more propitious to call for greater attention to lung cancer. Early detection of the disease through screeningon an experimental and study basis in our legal system, represents an example of the importance of secondary prevention which, together with the fight against smoking, determines lives saved, more quality of life and effectiveness in the care pathways, in addition to the sustainability of the health systems of tomorrow “.
It is a “challenge with a strong ethical and moral significance”, underlines Scagliotti, “and we cannot be dismissed in the face of evidence like the ones we have accumulated over the last 20 years. the level of communication must be increased. We need to go to shopping centers “in people’s daily lives. How often should lung screening be done?” The real bet – says Pastorino – is to do it based on risk, not to do everything the same for everyone, but a different strategy that includes an annual frequency for all those with a very high risk over a longer interval, even 3-4 years, for those with a very low risk. In this way we could improve the cost-benefit of a screening strategy from all points of view. “The fundamental point, concludes Scagliotti,” is to get to diagnose the disease first. And this will produce, without doing anything, a doubling of 5-year survival. And then, for that number of patients who are still diagnosed at an advanced stage, act on improving survival “.
#appeal #lifesaving #lung #Tac #screening #enter #Lea