Twenty million euros. This was the figure allocated nationally by the 2021 Budget Law for the provision of genomic tests for breast cancer. To be precise: tests that, in some selected patients with early stage hormonal breast cancer (about 70% of cases), can help doctors understand when to administer chemotherapy and when, instead, it can be avoided .
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The request for data: what will happen
The question now is: have these funds been used by the regions? How and how much? And here we come to the news: to know exactly the situation, this week Cittadinanzattiva sent the request for civic access to the presidents and regional health councilors who, by law, will have to give feedback within sixty days. Or we will move on to appeals.
Breast cancer, genomic tests indicated for one patient in 5. But not everywhere they are available
by Tiziana Moriconi
The application will allow for the collection of numerous information: the organizational methods for the prescription, execution, use, monitoring, verifications and controls of the tests; the terms of the individual regional resolutions; the share of the fund assigned to each Region or Autonomous Province; the number, type and costs of the tests carried out in 2021 and 2022; the percentage of patients tested compared to how many would have been entitled; the percentage of patients tested from other Regions / Autonomous Provinces; any additional appropriations at regional level.
Genomic tests, a right not guaranteed everywhere
“From a survey we published last March and from what patients report to us, we know that there is a lot of discrepancy in the area”, he tells Salute Seno Valeria FavaHead of Health Policy Coordination of Cittadinanzattiva: “Sometimes it is the clinicians themselves who report to patients that they do not have the test available. In some Regions, such as Lombardy, they have been using them in clinical practice for some time and in a consolidated way, having have also been able to have their own resources, while other regions are further behind. Some have reached the limit of the fund, others are not using it. And if they are not used for genomic testing, these resources are lost.
We know the situation roughly, but we don’t have the details. Hence the instance. Pending the inclusion of the test in the essential levels of assistance (Lea) – currently blocked by the non-approval of the tariff decree – it is necessary to guarantee the use of the allocated funds and equal access to tests for all patients “.
Breast cancer, 6 out of 10 patients are not prescribed genomic testing
by Irma D’Aria
Today, genomic testing is recognized as an important tool in breast cancer guidelines. According to recently released data, on average, in Italy, 40% of the patients who would be candidates access the test. In the aforementioned Lombardy, the percentage rises to 80%: here it is estimated that by the end of 2022 a total of 1,500 tests out of the 1,800 planned will have been carried out.
Why breast cancer genomic testing is important
Failed tests represent a missed opportunity. First of all for the patients, who could avoid unnecessary toxicity, and secondly for the regions themselves and for the socio-health system, which is bearing the direct and indirect costs of avoidable treatments.
According to some studies, genomic testing can save up to 75% of unnecessary treatment after surgery. “A failure from an ethical point of view and also from a sustainability point of view”, Fava concludes: “For this reason we, together with other associations and scientific societies, have requested that both genomic tests and tests with NGS technology (advanced gene sequencing technologies , ed) are included in the LEA “.
Breast cancer, who to ask if they are treating me right?
by Alberta Ferrari *