One year after the regional oncology and hemato-oncology network launched new projects such as the “return to screening” for women who have undergone breast cancer surgery after 10 years of follow-up and the strengthening of psychology services dedicated to young cancer patients and their family members and caregivers
February 1, 2024 – La prevention first of all. In Emilia Romagna participation in free screening programs (breast, cervix and colorectal) is higher than the national average. But the news is that women who have undergone breast cancer surgery in the region, after ten years of follow-up at the Senology Centres, they are reinserted into the mammography screening program – the so-calledreturn to screening” – to reduce abandonment of the surveillance path.
A one year from the establishment of the regional oncology and haemato-oncology network and on the occasion of February 4, World Cancer Daywhich this year has as its theme “Closing the cure gap – Everyone deserves access to cancer treatment”, the Emilia Romagna region reiterates its commitment to the fight against cancer by supporting the three regional screening programs, strengthening the quality of care provided by dedicated centers and committing itself to the development of proximity and precision oncology. And throughout the territory, thanks to the work of health and hospital companies and voluntary associations, they will take place prevention and awareness initiatives.
“Prevention, management, assistance and treatment. For the Emilia-Romagna Region – underlines the councilor for health policies, Raffaele Donini– are the key words for the fight against cancer. The numbers continue to show that taking up free screening programs is critical, but we can do even more. Since last year, the regional oncology and hemato-oncology network has been an innovative model that puts the person at the center and the first projects launched are proof of this, such as the path for the long-term surveillance of women with a previous diagnosis of breast cancer or the strengthening of psychology services dedicated to young cancer patients and their families and caregivers”.
Mortality and number of tumors decrease
In Emilia-Romagna the percentage of participation of the female target population (women in the 45-74 age group) in breast cancer screening turns out stable (71% in 2022 and 2023), in slight increasefrom 65 to 66%, that allo cervical screening (women between 25 and 64 years old). Stable it is also adhesion to the colorectal screening, which involves men and women between 50 and 69 years old, is fixed at 53%. Numbers that can still be improved especially with regards to participation in the colorectal cancer screening program, which is the second most common cancer and deaths considering the male and female population together.
There is another positive fact. Thanks to the screening, based on the Cancer Registry data processed two years ago on previous years, the cancer mortality rate drops by more than 50% for all three forms of cancer, new diagnoses decrease (40% reduction for cervical cancers and approximately 27% for colorectal cancers), and there was a 31% reduction in advanced forms of breast cancer. Furthermore, the general trend of mortality it is decreasing in both men and women (14,081 deaths in 2018, equal to 28% of general mortality, and 13,358 deaths in 2022, equal to 24%).
It’s also good decrease in the trend of tumors over time. Cross-referencing the data from the regional tumor registry and the mortality atlas of the Emilia-Romagna region, it appears that the incidence rate of new diagnoses has dropped: it was 855 for men and 561 for women in 2006, while the 2023 estimates speak of 596 for men and 507 for women.
The “return to screening”
At the beginning of 2024, as part of the regional network coordination of breast care centers (Breast Unit), the so-called “return to screening” for women with previous breast cancer after 10 years of follow-up at Senology Centers. By “return to screening” we mean the passage for women with previous cancer into the age ranges foreseen for the active, controlled and systematic acceptance of population screening programs. This step aims to reduce the abandonment of the surveillance path by women over the years and the inequalities of access. The proposal, shared with the Territorial Screening Centers and women’s associations, is one of the actions promoted within the Regional oncology and hemato-oncology network.
One year of the oncology and hemato-oncology network
The first year of activity was also positive Oncology and haemato-oncology network of Emilia-Romagnaamong whose objectives there are i oncology services increasingly closer to the patient’s home – between community homes, community hospitals, home care and telemedicine – and services capable of providing personalized treatments based on diagnostic tests carried out in centers with a high level of biomolecular specialization. They were born in 2023 four diagnostic platforms for molecular biology analyses with the Next Generation Sequencing (NGS) technique at the University Hospital of Parma, the University Hospital of Modena, the IRCCS University Hospital of Bologna, the ASL Romagna (with the IRCCS “Dino Amadori” Meldola and the Pievesestina Laboratory, both in the province of Forlì-Cesena). In December 2023, the establishment of the Molecular Tumor Board (MTB), of a multidisciplinary nature, which has the task of identifying, on the basis of the results obtained from NGS molecular analyses, personalized therapies for the treatment of cancer patients who have exhausted the standard lines of therapy for their disease, on the basis of most advanced scientific knowledge and active drugs available.
Again with a view to optimizing and highly specializing the services offered, in 2023 the Metropolitan hematopoietic stem cell transplant programs based in Piacenza-Parma, Modena-Reggio, Bologna, Ferrara and Romagna.
Initiatives were then launched for strengthening of psychology services dedicated to young patients oncology and their family members and caregivers, through the training of child and adolescent psychologists and psychotherapists and with awareness-raising activities in schools. The project for pediatric patients will continue this year.
Finally, the Region has defined the priority strategic lines for the prevention and fight against cancer in implementation of the National Oncology Plan 2023-2027, which provide for the gradual extension of the regional colorectal screening program to the 70-74 age group, and the definition of a single regional model for PDTA onco-haematological (Diagnostic Therapeutic Assistance Path).
To know more
What is the Emilia-Romagna Oncology and Hemato-Oncology Network
The Emilia-Romagna Network was born in a reality equipped with structured and organized Oncologies and Hemato-oncologies which in all the provinces have already offered, since 2006, high levels of service for which the Region has long been committed. The Guidelines, approved by the Regional Council on 27 December 2022, define the general characteristics of the regional network according to the model of Comprehensive Cancer Care Networkwhich guarantees, while respecting local autonomies, the greatest possible uniformity in terms of access, clinical management, governance and monitoring of data for both clinical and research purposes.
One of the strengths of the model is proximity oncologywhich allows us to offer oncology and hemato-oncology activities in the area – Community Homes and Community Hospitals, right up to the patient’s home – guaranteeing the same conditions of efficacy and safety. A strong boost will then come from telemedicine which, while not replacing in-person visits, will allow for timely discussion of diagnostic tests and the detection of any signs of recovery of the patient. The Regional Oncology and Hemato-oncology Network also focuses on research and development of innovative therapies.
Screening programs in Emilia-Romagna
Screenings play a central role in cancer prevention and are an example of integrated networks, managed in Emilia-Romagna with a multi-disciplinary and multi-professional approach that accompanies the person in all phases of the process: from diagnosis to treatment and follow-up for lesions precancerous.
Data updated to 1 January 2024 confirm the total recovery of membership in the screening programs of Emilia-Romagna: 71% of women in the 45-74 age group with mammography performed in the screening program for the early diagnosis of breast cancer (annual for 45-49, biennial for 50-74) ; 66% of women aged 25-64 took part in the screening test for the prevention and early diagnosis of cervical cancer (HPV test/Pap test); 53% of people aged 50-69 are covered by the colorectal cancer screening program (men and women). Participation is higher than the national average for all three screenings.
The importance of early diagnosis for breast and cervical cancer has been confirmed: in the target population -40% incidence of cervical cancer and -50% mortality. For women who participate in mammographic screening: -56% mortality from breast cancer and -31% from advanced forms of breast cancer.
Screening via fecal occult blood testing has proven to be very effective in Emilia Romagna, the most updated data report for those who participate: -33% new tumors and -65% mortality in men, -21% new tumors and -54% mortality in women. Therefore, to further reduce the burden of colorectal cancer, it is essential to activate further initiatives to solicit the 47% of men and women aged 50-69 who do not respond to the invitation for colorectal screening.