‘Oncology is missing in the electoral programs’, Aiom appeal to politics

“Oncology is lacking in the electoral programs. We have read only vague hints of the need to resume screening interrupted during the” Covid “pandemic,” but there is no system vision that places prevention at the center of the fight against cancer, which it must also include the reduction of access times to innovative drugs and the greater diffusion of genomic tests. We ask the coalitions to consider these fundamental issues. Only in this way can we save more lives and ensure the sustainability of the health system “. This is the appeal launched by Saverio Cinieri, national president of AIOM (Italian Association of Medical Oncology), in a press briefing at the ESMO Congress (European Society of Medical Oncology), which opens today in Paris. “Due to the pandemic – he recalls – screenings for breast, cervical and colorectal cancer recorded a reduction of 2.5 million examinations in 2020 compared to 2019. Missed diagnoses were also estimated: over 3,300 for breast cancer, about 1,300 for colorectal (and 7,474 fewer adenomas) and 2,782 precancerous lesions of the uterine cervix. It is not enough to refer only to the need to restart these secondary prevention programs, which remain fundamental “, warns Cinieri . “We need a real recovery plan that starts from healthy lifestyles: no to smoking, correct diet and constant physical activity – specifies Giuseppe Curigliano, member of the Aiom national board, professor of medical oncology at the State University of Milan and director of the Development Division of new drugs for innovative therapies of the European Institute of Oncology (Ieo) of the Lombard capital – The example is represented by the European Plan for the fight against cancer, approved on February 3, 2021 and divided into 10 flagship initiatives and multiple actions of support. The objectives, the resources available and the time required are identified for each “. Every year in Italy there are 377 thousand new diagnoses of cancer, underlines the AIOM, highlighting that 40% of cases and 50% of cancer deaths can be avoided by acting on preventable risk factors, precisely on lifestyles, “almost completely absent “in the programs of parties and coalitions. Yet the annual cost of cancer in our country is 19.3 billion euros, the specialists note. In 8 years, from 2014 to 2021, spending on cancer drugs increased by 73% from 2.3 to 4 billion. Faced with a constant growth in expenditure for cancer treatment, five-year survival is improving more and more, reaching 65% in women and 59% in men (it was 63% and 54% in the previous survey updated to 2015. ). A result obtained thanks to the prevention campaigns and innovative therapies, which in many cases make it possible to make the disease chronic or to obtain healing with substantial savings in other items of health and social expenditure, and which oncologists ask to enhance and extend. The main oncological risk factor is “cigarette smoking, associated with the onset of one out of three neoplasia and 17 types of cancer, in addition to that of the lung – adds Cinieri – Not only that: also a correct diet and regular physical activity can reduce the risk of developing the disease by up to 30%. Physical movement has preventive and therapeutic effects and can be compared to a drug that, when properly administered, prevents serious diseases such as tumors and prevents their development, guaranteeing considerable benefits to citizens and savings to the health system. It is estimated that in Italy behavioral risk factors, and therefore modifiable, are responsible every year for about 65 thousand deaths from cancer and cigarette smoking has the greatest impact with 43 thousand deaths “.” Despite these evidences – observes President Aiom – there are still too many sedentary people: in our country, 31.5% of the population does not practice any sporting activity, 3 2.5% are overweight and 10.4% are obese. These numbers are increasing among people with cancer. As many as 38% of cancer patients are completely sedentary, despite the proven benefits of physical activity in preventing relapses and, more generally, in controlling the disease “. In addition,” access times to new therapies must be shortened – he insists Curigliano – The time that elapses between the filing of the authorization and evaluation dossier with the EMA, the European regulatory agency, and the actual availability of a new drug in the Italian Region that first makes the treatment available, is about 2 years and this long process can severely penalize the sick. The future challenge is to arrive at a personalized prevention for each person based on genetic risks, and therefore not modifiable only with lifestyles. Only a development of organization, therapy and personalized prevention will be able to offer such benefits as to maintain the sustainability of the health system, healing an increasing number of patients “.” Precision oncology – the expert points out – today includes effective weapons such as therapies and immunoncology that allow to extend survival even in metastatic disease, in some cases making it chronic. Genomic tests are also included in precision oncology, which make it possible to limit the use of chemotherapy after surgery in women with early stage breast cancer. The publication in the Official Journal of the ministerial implementation decree dates back to July 2021, which released the 20 million euros of the Fund dedicated to the free application of these molecular analyzes, which, however, are not yet used uniformly throughout the territory. The length of bureaucratic procedures at the regional level must be overcome – Curigliano warns – so that all patients have the possibility of accessing genomic tests “.