Europe wants Member States to screen more people for more types of cancer. In Flanders there are not many reasons to change much. “The family doctor can determine if an exam is useful.”
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The more tumors that are detected at an early stage, the better the patient’s chances of survival. The European Commission presented ideas this week to improve early detection. By 2025, he wants 90% of eligible people to be offered effective cancer screening for breast, cervical and colon cancers. Screening should also be extended to include prostate, lung and stomach cancer.
An inter-cabinet working group met on Friday morning, including participants from the public health sector. This included the position of the Agency for Care and Health, along with that of the Center for Cancer Detection.
breast cancer
A more surprising European suggestion was to expand the target group of women for breast cancer screening to 45-74 years, from 50-69 years.
‘This is a large group and if I were to screen there, it would incur a large additional cost. There is no objection to this per se, but there is no evidence that it is useful, “says oncologist Erik Van Limbergen (KU Leuven).” Breast cancer in patients under the age of 50 is often observed in groups high-risk family members. They are already well monitored. The number of cancer cases is very limited in the rest of the younger population. ”
Expanding to an older age group is more useful, although this should not be done through a large population survey. “In specific cases, the general practitioner could determine if an exam is useful, for those who still have a good life expectancy, say fifteen years,” says Van Limbergen.
lung cancer
There is currently no general screening for lung cancer in our country, although specialists certainly see benefits for heavy smokers. Again, Europe proposes to subject high-risk groups – heavy smokers – to preventive examinations. Specifically, these are smokers with more than thirty ‘pack years’ at the counter. This means that you have smoked twenty cigarettes a day for thirty years.
“This should be studied, especially if smoking cessation counseling is also used, because prevention is always better than cure,” says Center for Cancer Detection director Patrick Martens. ‘Work has been ongoing on such screening for some time, but this is not evident from a population screening point of view. For example, you don’t know who smoked that amount. You must collect this information in a certain way, in a way that respects privacy. You have to evaluate something like this step by step. ‘
Other tumors
Europe wants early screening for prostate cancer, but scientists point out that in our country, prostate cancer is very often detected at an early stage (1 or 2). The five-year survival rate is 98%. This is already very good. Does systematic screening still offer many benefits? There is a high risk of overdiagnosis and overtreatment. About a third of prostate cancers progress so slowly that you will never have them. The treatment has potential drawbacks such as impotence and incontinence, but no benefit. ‘
There is also the advice to switch for cervical cancer from the traditional PAP test to a specific HPV test every five years from the age of 30. ‘Autosampling is also possible there, which is not possible with the PAP test. This has already been started, but again it is important to qualitatively develop the entire screening process from invitation, correct accessible information, tests, results, registration and follow-up first. ‘
Europe also proposes to increase screening for colorectal cancer from 55 to 50, even if this is already happening in our country.
For the moment, the Flanders vision is a point of view that ultimately needs to be examined by the member states through a federal council at the European level. Only then will a concrete plan be proposed by Europe.
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