proyecto de la unión europea – grupo europa contra el cáncer
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I Jornada Técnica de la ESTRATEGIA EN CÁNCER DEL SISTEMA NACIONAL DE SALUD
Madrid, MSC, 25 y 26 de Junio de 2007.
PROYECTO DE LA UNIÓN EUROPEA: GRUPO EUROPEO CONTRA EL
CÁNCER
Alfredo Carrato Catedrático y Jefe de Servicio Oncología Médica
Hospital Universitario de Elche, Univ. Miguel Hernández
CANCER CHARACTERISTICS
Cancer Incidence Rates*, All Sites Combined, All Races, 1975-2000
*Age-adjusted to the 2000 US standard population.Source: Surveillance, Epidemiology, and End Results Program, 1973-1999, Division of Cancer Control and Population Sciences, National Cancer Institute, 2003.
0
100
200
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70019
75
1976
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Both Sexes
Men
Women
Rate Per 100,000
SITUACIÓN DEL CÁNCER EN ESPAÑA 2003
• 162.000 nuevos casos y 95.000 defunciones.• El cáncer es la primera causa de fallecimiento por delante de las
enfermedades cardiovasculares.• Uno de cada 3 hombres y una de cada 5 mujeres se diagnosticarán
de cáncer en algún momento de su vida.• El cáncer colorrectal es el más frecuente con 25.600 casos nuevos
anuales• Los más frecuentes:
– en hombres son el de pulmón (16.600 nuevos casos/año), el colorrectal (14.204) y próstata (13.212).
– En mujeres el de mama (15.979), colorrectal (11.461) y útero (7.164).
• Supervivencia a 5 años (57%): 64% en mujeres y 50% en hombres
Gene-Environment Interaction and Likelihood of Developing Cancer
A cancer gene could be expressed without any environmental influence oronly when activated by environmental factors. Lichtenstein P. N Engl J Med 2000; 343:78-85
FRENTES EN LA LUCHA CONTRA EL CÁNCER
• Aumento de conocimientos sobre la biología del cáncer (Incremento de la investigación básica, traslacional y clínica)
• Prevención primaria (Hábitos saludables, fármacos, cirugía, etc.)
• Prevención Secundaria (Diagnóstico precoz)• Mejorando el diagnóstico (Innovación tecnológica)• Mejorando el tratamiento (Fomento de la investigación
traslacional y clínica. Nuevos fármacos y estrategias. Tratamientos individualizados, administrados por profesionales bien entrenados)
Tobacco Use in the US, 1900-2000
0
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3500
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1900
1905
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Year
Per
Cap
ita C
igar
ette
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sum
ptio
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10
20
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60
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100
Age
-Adj
uste
d Lu
ng C
ance
r Dea
th
Rate
s*
*Age-adjusted to 2000 US standard population. Source: Death rates: US Mortality Public Use Tapes, 1960-2000, US Mortality Volumes, 1930-1959, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002. Cigarette consumption: US Department of Agriculture, 1900-2000.
Per capita cigarette consumption
Male lung cancer death rate
Female lung cancer death rate
Trends in Obesity* Prevalence (%), By Gender, Adults Aged 20 to 74, US, 1960-2000
*Obesity is defined as a body mass index of 30 kg/m2 or greater. Source: National Health Examination Survey 1960-1962, National Health and Nutrition Examination Survey, 1971-1974, 1976-1980, 1988-1994, 1999-2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.
1311
161512
1715
13
17
2321
26
3128
34
0
5
10
15
20
25
30
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40
45
Both sexes Men Women
Prev
alen
ce (%
)
NHES I (1960-62) NHANES I (1971-74) NHANES II (1976-80)NHANES III (1988-94) NHANES 1999-2000
Supervivencia a 5 años en cáncer en la UE
• Justified by the challenge that cancer represents for Europe on the human, scientific and political fronts.
• The Alliance had come about as a result of a proposal made by European Ministers of Health in April 2005.
• Twenty-three representatives from European Member States were present at the first meeting in Paris, December 13, 2005
• There was a presentation by each country of their national organisation in the area of cancer, key challenge, innovative area of working and expectations from the Alliance.
• Policies, programmes and projects implemented by the European Commission were also presented.
European Alliance Against Cancer
Mission Statement
• "Cancer is a major health challenge for Europe. It is the secondcause of mortality and more than two million new cases are recorded each year.
• The European Alliance against Cancer aims:
• To define, promote and offer joint actions through voluntary cooperation to strengthen national measures and to ensure equal access to prevention and treatment for all European citizens, and to improve outcomes including patients’ overall experience of care.
• To explore ways of supporting research efforts and their implementation into practice."
Discussion on suggested areas of collaboration
• Clinical guidelines - Teresa Moss, UK • Tumour Banks* - Marcella Mottolese, Italy (E de Álava)• High throughput technologies* – François Amalric, France
(X Bustelo)• Education and Training* – Miklós Kásler and Maria Godeny ,
Hungary (A Carrato)• Clinical trials database – Thierry Le Chevalier, France• Primary prevention -Harald Zur Hausen, Germany• Secondary prevention. Sergio Pecorelli, Italy
Regina Elena Cancer Institute, Rome, Steering Committee Meeting, 27 April 2006
• 11 members of the steering committee were present at the meeting, representing 10 countries.
• In Europe, there are major differences in the level of health care between and within countries.
• EAAC was set up as an Alliance focused on political issues in cancer and therefore one of its objectives is to set the minimumservice which should be available in Europe
• Patients can move in Europe to get treatment with E112 documents which allow patients to be treated in another country because the ‘best treatment” is not available in their own country.
Educational Working Group MeetingNational Institute of Oncology, Budapest, 17th July, 2006
• Discussion about the educational systems of the present representatives (3) of the participant countries (9).
– Christine Lepage (EAAC member, France)– Alfredo Carrato (Spain) – Maria Gődény (Hungary) – Breborowicz (Poland)
• Minimum Recommendations have to be pointed for– Undergraduate programs (medical faculties, universities) – Graduate programs (resident’s training)– CME
Tumor Bank Working Group MeetingRegina Elena Cancer Institute Rome, 7th December, 2006
Distribución de tareas entre los miembros del equipo:
• preparar un documento para los Ministros de Sanidad de cada nacioón acerca de las condiciones mínimas que deben tener los bancos de tumores europeos,
• Una guía para la promoción de bancos nuevos, como para la acreditación de bancos ya existentes, allá donde aún no se hayan puesto en marcha sistemas de acreditación de biobancos (cualquier lugar excepto UK).
Budget
• France would finance the work of the Alliance and host the secretariat during the first year of its activities.
• It was agreed that each country should be asked to make a contribution to an initial budget for the next three years of the EAAC's activity and that individual working groups could also look for further funding from other sources such as the EC.
• It was agreed that industry funding for meetings was not acceptable.
• France, Germany, Italy, Portugal and Spain all thought that theywould be able to secure funding. Representatives from Hungary, Ireland and Luxembourg were not able to commit without further consultation and the Teresa Moss, for the UK, was sure that she would not be able to secure funding.
FACTORES CRÍTICOS PARA EL ÉXITO EN EL PROGRESO DE LA ONCOLOGÍA
Impulsar la colaboración entre todos los sectores y centrarla alrededor del paciente
Gobiernos Nacionales
Unión Europea
Agencias Reguladoras
InstitucionesAcadémicas
y otros ...
IndustriaFarmacéutica
Paciente
InstitucionesClínicas
Sociedades Científicas
Centros de Investigación
Incremento inversiones en prev formac asist e investig cáncer
¡¡Gracias!Gracias!
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