Among the proposals: screening and vaccines in the places closest to citizens, creation of cancer registries in all regions, building of a national portal of innovation, promotion of the law on the right to oblivion.
A year ago, Cittadinanzattiva gathered around a virtual table more than 60 people including representatives of institutions, of universities, of the research field, of civic and patient organizations, and of the private sector, inaugurating a long series of meetings with the aim of defining a long-term strategic vision in the fight against cancer in our country. At the center of the debate was a reflection on the Covid-19 pandemic situation and the emergency of suspended or cancelled ordinary treatments due to Covid: 4 million cancer screenings were postponed between 2020 and 2021; and between 50-80% of surgeries were postponed, even in the oncological area. The new wave linked to the Omicron variant has led many local health authorities (ASL in Italian), often on entire territories, to block again the programmable services and provisions.
It is from these premises that the document "Together for the oncology of the future" was born. It was presented last January 18th, 2022, by Cittadinanzattiva, with the support of Novartis, and realized thanks to the contribution of about 60 experts from patient associations, scientific societies, and the healthcare, academic and institutional world. The work was also guided by the European Plan against Cancer, built on four pillars (Prevention, Early Diagnosis, Treatment and Quality of Life) and the National Resilience and Recovery Plan (NRRP) which focuses on innovation, digital health, proximity care, social inclusion, and management of chronicity.
"We imagined the oncology of the future as a vision, a goal to strive for, in line with the thinking and commitments contained in the European Plan against Cancer, and consistent with an idea of collective public health, oriented to cross national borders, to make Europe a European Union of health, as promised by the President of the European Commission", claims Anna Lisa Mandorino, secretary general of Cittadinanzattiva. “At the same time, the proposals contained in the document can find space and ways to materialize through the new National Oncology Plan soon to be published. A plan that we hope will provide precise actions and resources - human, economic and technological - adequate to be able to implement it throughout the country".
"Our priority must now focus on the resumption of oncological screening, examinations, treatments and taking care of patients, in a homogeneous manner throughout the country, beyond any form of internal inequality. To do this, we need a strong organizational capacity, both at national and global level, with well-defined roles, with greater investment in training of health personnel and with the revision and updating of regulations for access to the most innovative treatments. With a view to a shared effort between science and community, this document proposes, thanks to the contribution of numerous professionals, skills and experience, to design a proactive strategy against cancer tailored to our country and intended for the main tables of policy makers," writes Professor Walter Ricciardi in the introduction to the document.
Numerous are the proposals and actions contained in the document in the four areas also provided by the European Cancer Plan:
PREVENTION. Among the proposals those of drafting Memoranda of Understanding between the various ministries to bring health education and training, as well as prevention (screening and vaccines) closer to people, in schools, workplaces, social centers of aggregation (ex. senior centers, sports clubs), as well as those "inhabited" by individuals in disadvantaged conditions (ex. penitentiaries); encourage adherence to vaccination and cancer screening, focusing on the Community Houses provided by the National Resilience and Recovery Plan (NRRP), facilitating the booking and active call systems (ex. through digital tools, apps); facilitate the treatment process and the taking into care of the patient.
ACCESS AND EQUITY TO CARE. In this area, the document proposes among other five priority interventions to establish by 2022 at the Ministry of Health the Steering Committee on the National Oncology Plan (NOP) to support, monitor and evaluate the implementation and effectiveness of the latter; to accelerate the use by the Regions of the fund allocated for the realization of regional cancer registries; to extend innovative models of distribution and administration of cancer drugs in territorial branches (ex. Community Houses), community pharmacies or at the patient's home; to increase the minimum number of hours of home care and provide a structural adjustment to the patient's home (ex. home automation); to introduce through a national law the figure of the psycho-oncologist to support both patients and health professionals.
INNOVATION. To establish and open, under the control of the Ministry of Health, a "National Portal of Innovation" that contains the list of the centers authorized to provide highly specialized and personalized treatments, the volume of services of each cancer center, ways on how to enroll patients in clinical trials with particular attention to the pediatric oncological population, as well as research protocols and HTA processes; to modernize the technology park using the resources of the NRRP and allow investment in new diagnostic techniques ensuring minimum standards of quality and safety both in hospitals and in the territory.
PATIENT QUALITY OF LIFE. Simplify the pathways for the activation of the application for civil disability since the time of diagnosis, circulating throughout the country the good practice of the "introductory oncology certificate"; to promote a law on the right to oblivion that allows all former cancer patients to no longer have to declare that they have suffered from cancer when re-entering the labor market or when trying to access financial services (ex. mortgages and insurance policies).
(Translated by Maira Cardillo, Active Citizenship Network staff)