ESMO 2016 Showcases Alternatives to Increase Participation in Cancer Screenings

ESMO 2016 Showcases Alternatives to Increase Participation in Cancer Screenings

Though most cancers are now treatable when caught early, including cervical cancer, participation rates for cancer screening worldwide are low, even when these screening programs are free. To help remedy that, the European Society for Medical Oncology Congress (ESMO 2016) focused on finding ways to improve participation of cancer patients in early screenings to improve survival rates.

ESMO 2016 showcased five studies on this important area of cancer management. The event took place Oct. 7-11, in Copenhagen..

Three of the studies presented at ESMO 2016 were led by French investigators. One was held by professor J-F. Morére, who led the EDIFICE1 survey meant to increase scientific insight into participation in screening programs in France.

“In this Fourth Nationwide Observational Survey [EDIFICE1], we hypothesized that individual opinions may affect physicians’ and laypersons’ attitudes toward prescribing or participating in screening; we assessed physicians’ and laypersons’ opinions, focusing on colorectal, breast, cervical, prostate and lung cancer screening,” Morére said in a press release.

“In general, screening was more reassuring than worrying, more so for physicians than for laypersons,” he said. “The official guidelines for colorectal and breast cancer screening are a good setting for GPs’ medical practices. The most widely used screening programs for colorectal, breast and cervical cancers enable GPs to make objective prescriptions, regardless of individual opinions. In the absence of guidelines, prescription rates are correlated with physicians’ confidence in screening. Reassurance in screening was found to have a positive impact on laypersons’ participation rates,” he said.

The second French study assessed smokers’ intentions to take part in a hypothetical lung cancer screening program. Two robust analyses were performed in current and former cigarette smokers to pinpoint factors linked to the intention to take part in the program.

The authors concluded that the intention to take part in the lung cancer screening program is a complex decision and explanatory factors differ between current and former smokers. Among current smokers, participation was mainly driven by their intention to quit smoking.

The third French study presented at ESMO 2016 was led by Marc Bendiane, who analyzed second cancer screening among five-year female cancer survivors to highlight the lack of information on cancer screening practices among long-term cancer survivors.

Bendiane found an under-utilization of mammography screening in these cancer survivors (non-breast cancer), versus women in the general population (78% against 87%, respectively). The study concluded it is important to raise more awareness of the risks of second cancers (non-recurrent of the first cancer) among cancer survivors and physicians.

“Breast cancer screening is the most important determinant of quality of life of cancer patients after surgery. Screening decreases the chances of axillary lymph-node involvement, avoiding axillary dissections, the most worrisome sequela of cancer surgery: the arm lymphedema,” professor Virgilio Sacchini, of the University of Milan, said. “We know that breast cancer screening will need more personalization in our era of genetics, but by increasing the awareness and compliance of mammography screening, we can better identify high-risk patients to involve in more specific surveillance.”

A U.K. study, led by Tom Newsom-Davis, MD, was a one-year pilot of a nurse-led Acute Diagnostic Oncology Clinic (ADOC) in a district general hospital.

A significant proportion of cancer patients in Europe are diagnosed with their disease as the result of an emergency presentation (EP) to acute secondary care services. This route to diagnosis is linked to poorer survival rates and worse patient experience. Previous studies have concluded that EP patients usually present with a long history of symptoms (above 12 weeks) and that 70% of these patients had seen their GP in the days and weeks prior to presentation. Addressing EP of cancer is important when improving the outcomes of European patients because, in the majority of cases, an earlier diagnosis is feasible and can prevent emergency presentations.

“This pilot shows the feasibility of a nurse-led service based in an oncology department, and a high level of user satisfaction,” said Newsom-Davis. “This model of acute diagnostic oncology clinic should be considered as an addition to existing outpatient cancer diagnostic pathways.”

An Australian study was presented by Amanda Bobridge, PhD, from the University of South Australia, introduced a patient-centered approach to improve screening participation rates.

“An overwhelming percentage of respondents to our questionnaires would support a combined cancer screening service. Offering a combined, co-located service – a ‘one-stop cancer screening shop’ – has the potential to address barriers to screening (such as time constraints), improve participation rates and maximize utilization of public health resources,” said Bobridge.

Professor Sacchini concluded that “the studies being presented at the ESMO 2016 Congress should help encourage doctors and patients to respond to screening programs proposed by national health services.”

“Screening tests may help diagnose cancer at an early stage, before symptoms appear, he added. “When cancer is found early, it may be easier to treat or cure. In this particular period of extreme evaluation of cost/effectiveness ratio, screening is still the best investment for the health of our populations.”

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