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Slovakia’s cancer plan needs comprehensive oncological care network, says Rečková [Advocacy Lab Content]

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Slovakia needs investment in a comprehensive oncological care network aligned with the Europe Beating Cancer Plan and the National Oncology Programme, according to the head of Slovakia’s National Oncology Institute.

Oncological statistics in Slovakia lag the EU average said Dr. Mária Rečková, director of the National Oncology Institute, she stressed the importance of prioritising high-quality healthcare, research, and education.

Cancer represents 26% of all deaths, the second most common cause of death in the EU after diseases of the circulatory system. According to data from the National Health Information Centre, about 40,000 new cases are diagnosed every year, and in 2023, 13,498 people succumbed to cancer in Slovakia.

“Investing money and human potential in well-functioning and organised screening programmes is a long-term investment. If we build preventive measures, we do not have to spend so much on solving acute problems,” Dr Rečková told Euractiv.

Slovakia trails the EU prevention investment league tables, spending only 1% of health expenditure compared to the EU average of 3.4%.

Over 40% of cancer cases are preventable with healthy habits, such as maintaining a healthy weight, diet, and physical activity. However, in key indicators of health risk factors – smoking prevalence, alcohol consumption, and obesity prevalence – Slovakia ranks above the OECD average.

Screening rates crucial

Adequate spending on cancer care is a prerequisite for higher survival rates, with prevention and health promotion reducing the burden of cancer.

“In addition to creating healthy habits, there is also a need for a health system that can provide primary prevention, for example, in the form of HPV vaccination, and secondary prevention in the form of organised screening programmes,” Rečková added.

An analysis published by the Institute for Healthcare Analyses highlights that detection in the early stages of breast cancer is crucial for improving survival rates. Regular participation in mammography screening can substantially reduce the risk of death from breast cancer.

The impact early detection has on survival rates follows all cancer types, with breast, lung, colorectal, and prostate cancers posing significant challenges.

Slovakia struggles with below-average cancer survival rates and screening attendance. For breast cancer, the EU screening rate average is 60% compared to Slovakia’s 31% and the third worst survival rate. Colorectal and prostate cancer display the second worst cancer mortality, with lung cancer ranked sixth worst.

Lung cancer pilot project delayed

In Slovakia, there are more than 3,000 new cases of lung cancer and 2,000 deaths per year. A pilot lung screening project aimed at improving early disease detection was scheduled to commence in 2023, only to be postponed.

When asked about the delay, the Ministry responded that it is currently planning the expansion of screening programmes, including a lung cancer screening programme. Data is being collected and processed, and a standard procedure for lung cancer prevention has already been adopted.

Rečková said: “Slovakia will participate in EU initiatives such as Joint Action CanScreen. Within this project, the necessary processes are planned to be set up, and new cancer screening programmes, including lung screenings, are planned to be introduced based on the European recommendations.”

Education, and health literacy essential

Level of education and health literacy exacerbate health inequalities and have an impact on cancer screening rates.

“Individuals with higher levels of education were more likely to participate in cervical, breast, and colon cancer screening than those with lower levels of education. Educational differences in participation in cervical screening were significantly smaller in countries with an organised cervical screening programme,” Dr. Daniela Kállayová, the secretary of the Health Ministry’s Committee for Oncological Screening, told Euractiv.

In breast cancer screening, the largest inequalities are found in Austria, the Netherlands, Poland, Estonia, and Slovakia, with gaps of 12 to 19 percentage points between education groups.

Dr. Kállayová shed light on ways to improve oncological prevention: “First and foremost, it is important to increase people’s health literacy. Secondly, we have evidence from the published literature that prevention programmes are more effective if they are organised and properly evaluated. Thirdly, quality assurance must be maintained.”

Quality assurance aims to maintain set minimum standards and continuously improve the screening programmes to ensure high-quality access and diagnosis.

Prevention programmes needed

According to Dr Rečková, if a person is determined to take part in prevention programmes, they need to be more accessible. Slovakia can take notes from other countries where screening programmes are more successful.

“In those countries, we see how important it is to ensure a smooth pathway for the patient from screening to any necessary follow-up diagnostics. Measures such as appointment systems, allocated times for screening examinations, and seamless provision of necessary diagnostics and treatment would be helpful,” she added.

Slovakia is actively participating in European projects and initiatives in an attempt to improve the below-average oncological rates.

“We see a tremendous opportunity in the Europe Beating Cancer Plan to join forces with other member states in a common goal: reducing mortality and morbidity from oncological diseases through systematic steps in prevention, diagnosis, treatment, research, development, education, and the utilisation of new technologies and digitalisation,” Rečková remarked.

[By Filip Áč, Edited by Vasiliki Angouridi, Brian Maguire | Euractiv’s Advocacy Lab]

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