European Colorectal Cancer Days 2013

II. EUROPEAN COLORECTAL CANCER DAYS
BRNO 2013 - PREVENTION AND SCREENING: Stakeholder Meeting

What to do in the “era of the CRC screening guidelines”? Networking is the solution!

Pavel Poc, Member of the European Parliament
Ladislav Dušek, Masaryk University, Institute of Biostatistics and Analyses

Colorectal cancer (CRC) is still the most common newly diagnosed cancer and the second most common cause of cancer deaths in Europe. More than 200,000 Europeans die every year from malignant tumours of the colon and rectum. However, many of these deaths can be avoided. Effective and safe colorectal cancer prevention and early detection are the key factors which can reduce both incidence and mortality of the disease. CRC screening should be accepted as one of the most desirable forms of organized cancer prevention which is to be supported by modern health care systems. Methodical aspects and scientifically driven promotion of the CRC screening were the main topics of the previous conference European Colorectal Cancer Days (ECCD), held on 4-5 May 2012 in Brno, Czech Republic. Questions and statements from the attendees during public sessions, as well as final conclusions of the ECDD 2012, challenged the organizers to continue in this networking activity.

It has been widely documented in clinical trials that CRC screening really keeps the potential to prevent colorectal cancer and save lives. Furthermore, we live in the period which can be called “the era of the CRC prevention guidelines”, issued in 2010. The methodical gold standards are thus known and recommended as well as the measures of the functional screening. And indeed, many European countries have recently implemented CRC screening. However, the heterogeneity in design and in the content of the national prevention strategies is still significant in the European region. More intensive communication, feedback analyses of reached results and platforms to exchange experiences should be supported and facilitated in our continent. That is why we prepared the second year of the ECCD conference, focused on CRC prevention, its progresses, problems and potentials.

The international heterogeneity of models applied in the CRC screening implementation is warning signal which inevitably indicates that evidence-based medicine on its own is not enough. Although very important, scientific background covers only one of the several dimensions of a successful screening program. Published information cannot substitute practical medical care and experience. Strong managerial background and organization, adequate reimbursement of prevention, high quality of all associated services and compliance by the target population are also among the factors substantially contributing to the desirable lowering of the incidence and mortality of the screened cancer. First and foremost, screening must be widely practiced. More than ever before, we need to implement functional information systems monitoring performance and quality of the CRC screening programmes in real world of clinical practice and allowing unlimited communication and sharing the experience reached in individual countries.

Last but not least, we should not neglect communication which does not mean only programme promotion. Necessary harmony among all factors determining screening efficacy and effectiveness cannot be achieved without the vital and mutual support of national health care authorities, the politicians, patients, the health care payers and other stakeholders. The ECCD conference is intended as a networking event which should help to share up-to-date knowledge among participating countries and institutions. We are convinced that in “The Era of the Guidelines” the networking is really a functional solution. Following four points thus highlight most important attributes of the CRC screening which should be addressed in Europe:

Networking. Sharing of experience in transfer „Opportunistic CRC screening -> Population-based CRC screening“
Standardization. Solving of heterogeneity in quality assurance and quality control systems of the national CRC screening programmes.
Harmonization. Searching for the best model of data-based support and legislative background of the CRC screening, including call-recall systems.
Promotion. Supporting effective communication and “image-making promotion” of the CRC prevention as activity attracting attention of target population.

We hope that second meeting of the stakeholders supported by representatives of medical societies and patients´ organizations can again offer a functional platform and a stimulating atmosphere for fruitful exchanges on all of these problems and many other related issues.

On behalf of the Programme and Organizing Committees

Pavel Poc & Ladislav Dušek