Invitation to cancer screening is an investment which will pay off in the future

13. 12. 2013 | Institute of Biostatistics and Analyses of the Masaryk University (IBA MU)

The workshop “Cancer Screening Programmes in the Czech Republic and Importance of Personalised Invitation”, held on 5 December 2013 in the Clarion Congress Hotel Prague, was organised by the Institute of Biostatistics and Analyses at the Masaryk University in cooperation with the WHO Office in the Czech Republic, the Kolorektum.cz Initiative, and the Office of Member of the European Parliament Dr. Pavel Poc. The workshop was held under the auspices of Martin Holcát, MD, MBA (Czech Minister of Health), Alena Šteflová, PhD, MPH (Director of the WHO Office in the Czech Republic), and Dr. Pavel Poc (Member of the European Parliament).

Left to right: Renata Knorová, MUDr. Hana Šustková, Bohumil Seifert (Image credit: IBA MU)

Guarantors of Czech cancer screening programmes, representatives of the Czech Ministry of Health, health insurance companies and specialties involved in cancer screening, as well as other medical experts (76 participants in total) met in Prague two days after the official announcement by the Czech Ministry of Health that a project of personalised invitation to participate in cancer screening examinations would be launched. A discussion on short- and long-term impact and effects of this undoubtedly positive step was the main purpose of this meeting.

Personalised invitation has been recently confirmed by health care professionals and experts as the only way to increase the participation of Czech citizens in screening programmes of breast, colorectal, and cervical cancer. The coverage rate of the target population is currently over 50% in breast and cervical cancer screening, and only slightly above 25 % in colorectal cancer screening. However, these numbers represent a ceiling that cannot be overcome without a personal invitation of each individual who has not yet attended a screening examination.

Press conference, which preceded the workshop, was attended among others by the Czech Minister of Health Martin Holcát, MD, MBA, and was intended particularly for the journalists and media dealing with health care. Press release distributed within the press conference is attached at the end of this report.

Methodology for personalised invitation to cancer screening programmes in the Czech Republic, developed with a valuable support by the Czech WHO Office and the Czech Ministry of Health, was introduced at the beginning of the workshop by Assoc. Prof. Ladislav Dušek (IBA MU). The latest developments and current status of all three Czech cancer screening programmes were subsequently summarised by their guarantors – Prof. Jan Daneš (General University Hospital in Prague), Prof. Miroslav Zavoral (Military University Hospital Prague) and Vladimír Dvořák, MD (Centre for Outpatient Gynaecology and Primary Care, Brno). Assoc. Prof. Bohumil Seifert (1st Faculty of Medicine, Charles University in Prague) introduced the involvement of general practitioners in cancer screening; the attitude of health care payers was presented by Hana Šustková, MD (General Health Insurance Company), and Renata Knorová, MD (Czech Industrial Health Insurance Company).

Presentations of speakers stated above were ensued by a discussion, from which the following main points regarding the future of Czech cancer screening emerged:

Personalised invitation is a step that will turn the existing organised screening programme into a population-based screening programme. All three Czech screening programmes have a comprehensive diagnostic and information background at their disposal, which is well prepared for the expected increased attendance due to the personalised invitation, and is able to assess the project results quickly.
Invitation of the citizens must be accompanied by a high-quality information campaign, which is now under preparation. Top representatives of the specialties involved in cancer screening expressed their wish to contribute to the campaign form and content, at least at its final stage.
Long-term effects of personalised invitation and the inevitably higher participation in screening programmes are undoubtedly positive, as proven by a number of previously published studies: tumour detection in earlier stages, higher chance of a successful treatment, and lower expenses for treatment of advanced cancer. Physicians and health care payers, however, have pointed out that the short-term effect can be quite opposite. A higher number of people who have neglected prevention and would come to the screening examination for the first time would probably lead to a higher incidence of advanced cancers at the beginning (the so-called “harvesting effect”). Sending out letters and leading a health education campaign will therefore not be the only costs related to the project of personalised invitation; the expected higher number of diagnostic examinations and treatment of newly detected cancers will have to be covered as well.
The personalised invitation must be a sustainable project in order to achieve the long-term benefits in the form of improved cancer detection and lower mortality rates.