1. EUROCHIP-Italia in EUROCHIP-2 Health Indicators for Monitoring Cancer in Europe Public Health Program EUROPEAN COMMISSION: HEALTH & CONSUMER PROTECTION DIRECTORATE-GENERAL Italian Health Ministry

2. EUROCHIP-2 IS BASED ON THE RESULTS OF EUROCHIP-1 EUROCHIP-1: a public health project with meetings of large international consensus on the necessary information describing cancer and measures against cancer Aims: to produce a list of Cancer Health Indicators to help develop European Health Data Bank to reduce inequalities in cancer control www.istitutotumori.mi.it/project/eurochip/homepage.htm

3. The area of the disk is proportional to the Total National Health Expenditure ($ PPP) in the country $ PPP: Parity Purchasing Power per capita (US $) Sources: OECD 2002 for GDP and TNEH; EUROCARE-3 for survival Gross Domestic Product (1997) and 5-year- age- and cancer site- adjusted relative survival (women)

4. Total Prevalence, All Cancer m+f, 1992 Prevalence per 100 000

5. Main Public Health Strategies in Europe Wealthy areas: Primary Prevention, management of queues Less wealthy areas: Treatment and investment All: focus on the elderly

6. EUROCHIP-2 a European team-work for action A link between research and health authorities EUROCHIP-2 a European team-work for action A link between research and health authorities

7. - The EUROCHIP-1 Network - The European Imprimatur - A Process Approach who by? under which umbrella? through which phases? - The EUROCHIP-1 Network - The European Imprimatur - A Process Approach EUROCHIP-2

8. What’s needed? cancer data sources a) To liase with cancer data sources b) To encourage the set-up of data areas where information collection in areas where information is unavailable is unavailable quality and promote c) To check data quality and promote standardisation standardisation European health data d) To develop a European health data bank bank EUROCHIP-2

9. What must be done? Analysis a) Analysis of indicators’ behaviour deficiencies b) Identification of deficiencies and differences in Europe taking into account health politics EUROCHIP-2 IN ORDER TO actions Support actions to reduce inequalities in cancer control

10. Example of health indicator: Computed Tomography Scanners EUROCHIP-2 : PROCESS APPROACH

11. Computed Tomography Scanners and 5-year- age- and cancer site- adjusted relative survival (F)

12. EUROCHIP - Italia An Italian project involving cancer registries, screening programmes, IRCCS (Hospitalization and Treatment Scientific Institute), to disseminate knowledge and to promote actions for: reducing the probability of becoming ill increasing survival sorveglianza sanitaria better quality of life for patients REDUCING INEQUALITIES

13. Home page - www.tumori.net

14. The study of inequalities: a critical topic of public health Enables us to foresee what results can be achieved through correct health polities

15. 5-year-before diagnosis relative survival (%) age and cancer site-adjusted Italian Cancer Registries - EUROCARE-3, 1990-94 Ragusa: M 33%, F 44%; Varese: M 39%, F 53%; Romagna: M 45%, F 58%

16. 5-year-before diagnosis relative survival (%) Age -adjusted, Period Trends Varese&Ragusa Cancer Registries EUROCARE, 1980-94

17. Goal GroupsSTEPS Epidemiological estimates a)Mortality, Incidence, Prevalence and Survival Estimates for a selection of Cancer sites and Italian Regions b)Set-Up of Scientific Committee Cancer Registries a)Confrontation with International Data b)Link with other Information Systems of Epidemiology c)Coordination with AIRT website (in progress) Risk Factors a) Study of all Risk Factors-related literature b)Assessment and resume of prevalent factors in Italy Screening Programmes a)information on Screening related-activity b)Relazione con reti italiane di screening (GISMA e GISCI) Training and Information a)Interactions with Systems of Information b)Regular Data Publication to Press Southern Italy a)Data Assessment for Italy and Southern Regions b)Identifications of lacking regions EUROCHIP - Italia (I Tumori in Italia)

18. Source: Italian Oncology White Book, 2 Medical Oncology Unit Percentage with CTS, PET and Mammography. Macroregional data

19. Source: Italian Oncology White Book, 2 Medical Oncology Unit Percentage per facilities Macroregional Data

20. Proposal for new actions EUROCHIP - Italia