#EAPM - kaip balandis galėtų būti gegužės pabaiga ... (ir plaučių vėžio atrankos atvejis)

The UK premier was bunkered at her official country residence, Chequers, on Sunday (24 March) trying to save her political career, according to several reports.

No such troubles across The Pond for ‘the Donald’, though, where the US president must be feeling pretty pleased that he’s seemingly off the hook (if he was ever actually on it) about pre-election collusion with Russia and obstruction of justice.

President Trump was, of course, in celebratory mood on Twitter while, in contrast, 10 Downing Street is staying schtum about Mrs May’s intentions as a series of votes - some even possibly ‘meaningful’ - are set to swamp parliamentary business in the coming days.

Also, at the weekend, a huge march of ‘Remainers’ calling for a second ‘people’s vote’ on Brexit hit the headlines, alongside an online petition garnering millions of supporters also making waves and calling for Article 50 to be revoked.

Meanwhile, the EU for its part is totally aware that, however uncertain (read ‘bad’) things already are in respect of Brexit, there’s a chance they could get a lot worse. As ever, we wait…

Hopefully, by the time of EAPM’s 7thannual presidency conference) on 8-9 April things will be at least a little clearer, but nobody’s placing any bets. Register čia.

reklama

Regardless, it’s business as usual for the Alliance as, in partnership with the European Respiratory Society (ERS), it hosts an event on lung-cancer screening, entitled ‘The case for lung cancer screening: Saving Lives, Cutting Costs’.

(This also coincides with colorectal cancer month. Colorectal cancer is the third most commonly diagnosed cancer, and the fourth leading cause of cancer-related death.)

Skaičių žaidimas

We are all aware that by far the best way to reduce numbers of lung cancer patients is to persuade smokers to stop. Although not all sufferers are, of have ever been, smokers.

High-risk groups exist, of course, and early diagnosis is vital. Currently, five-year survival rates stand at a mere 13% in Europe and 16% over in America.

Pasak Pasaulio sveikatos organizacijos, tai dažniausiai nustatomas vyrų vėžys, o moterų plaučių vėžys - „nerimą keliantis augimas“.

Some one billion people on the planet are regular smokers. And figures show that lung cancer causes almost 1.6 million deaths each year worldwide, representing almost one-fifth of all cancer deaths.

Tuo tarpu ES viduje plaučių vėžys taip pat yra didžiausias visų vėžio atvejų žudikas, dėl kurio kasmet miršta beveik 270,000 21 žmonių (apie XNUMX%).

The ERS and the European Society of Radiology, have recommended screening for lung cancer under the following circumstances: “In comprehensive, quality-assured, longitudinal programmes within a clinical trial or in routine clinical practice at certified multidisciplinary medical centres.”

Tuo tarpu Tarptautinė plaučių vėžio tyrimo asociacija (IASLC) Strateginio atrankos patariamojo komiteto (SSAC) parengė konsensuso pareiškimą po NLST tyrimo paskelbimo, nustatydama klausimus, kuriems reikalingi tolesni tyrimai. Tai apima veiksmingą rizikos vertinimą ir atrankinio patikrinimo integravimą su informacija apie rūkymą.

SSAC ekspertai nurodė, kad, laukdami, yra geras atvejis „nedelsiant įgyvendinti kruopščiai suplanuotas ir tikslingas demonstravimo programas“.

Of course, cost-effectiveness questions arise whenever population-wide screening is considered, especially in relation to frequency and duration.

The UK lung cancer screening trial (UKLS) has demonstrated that screening is cost effective by NICE criteria, in the modelling of their pilot screening trial.

Galimos mažos CT dozės plaučių vėžio atrankos nauda beveik neabejotinai pagerintų mirtingumą nuo plaučių vėžio Europoje.

NELSONAS ir pergalė?

NELSON atliktas plaučių vėžio kompiuterinės tomografijos (KT) tyrimas parodė, kad toks patikrinimas padidina besimptomių vyrų riziką mirti nuo plaučių vėžio 26%.

Išvados taip pat parodė, kad atlikus atranką rezultatai moterims gali būti dar geresni.

"NELSON" 2003 perėjo Nyderlanduose ir Belgijoje, o galiausiai ji buvo sudaryta iš 15,792 individų kontroliuojamuose tyrimuose, o likusius žmones - ne mažiau kaip dešimt metų.

Dr Harry De Koning, of Erasmus MC in The Netherlands, said when presenting the results: “These findings show that CT screenings are an effective way to assess lung nodules in people at high risk for lung cancer, often leading to detection of suspicious nodules and subsequent surgical intervention at relatively low rates and with few false positives, and can positively increase the chances of cure in this devastating disease.”

Paaiškinus, kad NELSON buvo antras pagal dydį toks kada nors atliktas tyrimas, jis pridūrė: "Šie rezultatai turėtų būti naudojami informuoti ir nukreipti būsimą" CT "tyrimą pasaulyje."

De Koning will deliver a keynote address at the EAPM/ERS event.

NELSON demonstrated that, in its early stage, lung cancer has a very good prognosis over a five-year period which becomes a great deal poorer in later stages, as treatment by then has little effect on preventing deaths.

NELSON has also shown unequivocally that screening has the potential to detect lung cancer at an early stage.

EAPM executive director Denis Horgan said of the results: “NELSON certainly shows the benefits of lung-cancer screening, something we already knew. Now we will work even harder with our partners such the ERS, ESR and ECCO, to persuade policymakers across the EU that this is an urgent societal need.”

Kas toliau?

Kad patikra būtų ekonomiška, ji turi būti taikoma rizikos grupei priklausantiems gyventojams. Sergant plaučių vėžiu, tai nėra paprasčiausiai pagrįsta amžiumi ir lytimi, nes dažniausiai atliekama krūties ar storosios žarnos vėžio patikra.

Europe needs to involve all key groups in developing rekomendacijos and guidelines for implementation, adapted according to the health-care landscape of individual countries.

Įvairios valstybės narės jau parodė norą judėti pirmyn tikrinant plaučių vėžį, o renginyje dalyvaus kelių šalių sveikatos atašė.

Aljansas ir jo suinteresuotosios šalys supranta, kad, be kitų elementų, Europoje reikalinga: nuolatinė atrankinė stebėsena, reguliariai teikiamos ataskaitos; užtikrintas tikrinamų ataskaitų komentuojamų duomenų nuoseklumas ir geresnė kokybė; turėtų būti parengti ir priimti kokybės ir proceso rodiklių standartai.

The EU should put guidelines in place that will allow member states to set-up quality assured early detection programmes for lung cancer, and that there is a need for increased public-private partnerships, such as IMI II.

All of the above will be discussed at the lung-cancer screening event, and it is envisaged that a co-ordinated plan will emerge, which will make its way to Commission and Parliament policymakers and Member State health system chiefs.

It is clear than any further delay to the implementation of the best form of lung-cancer screening will mean many more unnecessary lives lost.

Brexit may still be uncertain. The value of lung-cancer screening, however, is not.

Norėdami užsiregistruoti EAPM’s 7th annual presidency conference on 8-9 April, please click čia.