In Turkey we have launched a phase II programme, a national cancer control programme, and we have some new highlighted news for the people here. For the cancer registry pillar of the programme we will open 81 cancer registry centres, once centre for each city which means that…

And you’ve got quite a high take-up, a lot of patients are going into this registry.

Yes. Registry centres, all cancer patients, 100% coverage for the whole country because we believe that cancer registry is the basis of all cancer control programmes.

What have you gathered, what data have you gathered so far?

The data is extremely wonderful because we have all the details of the cancer, cancer type, [?? 0:41] from each city so that not only the coverage of 20% of the whole country but 100% coverage of all cancer patients which means that you can now produce local cancer control programmes in addition to nationwide programmes.

Are there any surprises so far?

Of course. In some cities you’re faced with some other highlighting cancers which are not seen in other cities or other parts of the country. In some places not the breast cancer is the leading cancer in this city.

And the partner to this cancer, this active cancer registry, is of course screening.

Yes, screening.

So you’ve got some interesting screening going on, I know you’re looking at HPV aren’t you? Tell me about that.

Exactly. Turkey has on-going population-based cancer screening: colorectal, cervical cancer and breast cancer, but the news are coming from cervical cancer we have changed our screening strategy; starting in October we will screen all ladies over 30 years of age with HPV genotyping tests. So we will screen for 14 high risk HPV, if the patient is negative then she will go home for at least five years. If she is positive then we will do the genotyping, either she is HPV16, 18, 31, 33 or other else. Then the screening really will increase our coverage rates because we had low manpower in terms of pathologists and then this HPV genotyping, according to the scientific evidence, is more sensitive, at least having the same specificity with cytology and you don’t need extreme manpower for this programme and you can leave the lady at home for much higher years, the negative predictivity is much higher. This HPV screening also will be implemented into the European guidelines.

And you can use the Pap smears when and if necessary.

Of course, it will also continue. Then if it is necessary it’s always continued; we have cytological. If the lady firstly goes to the cytology screening still ongoing but this is another opportunity and it is independent of the number of the pathologists or pathology criteria.

Another news from the cancer screening is the breast cancer. Now we have more than 1,000 mammographies but additionally we will implement 130 mobile devices, mobile mammographies, while we do this. Because Turkey is a big country, it has a very huge surface area and in order to increase the access to the cancer screening we need the mobile devices.

How are you targeting that mammography though?

It’s the age 40 we start; it was 50 but now we are decreased to 40. Why we did it because when we look to our data coming from the active cancer registry centre what we realised that more than half of the ladies, breast cancer ladies in Turkey, were under 50 years of age and if you look to the age standardised rates of breast cancer in Turkey it’s much higher than Europe for age under 50.

So you’re pretty aggressive on breast cancer but you’re going easy on prostate cancer?

Well prostate cancer has not sufficient evidence for us now to start screening but breast cancer is the leading cancer in the ladies and in Turkey also since the breast cancer patients are young not only the mortality but the quality of life is really affected because it’s the young people, much more life and losing a breast is really dramatic for all ladies.

So you’re describing to me a lot of things happening in Turkey, could you summarise for me what you think the messages are for doctors in other countries to follow your model and to chase the right things to improve cancer care.

They really need 100% cancer registry because the registry brings you wonderful data and according to the national 100% coverage cancer statistics you can provide national and local cancer control programmes. The registry is the basis of cancer control. According to your own national data you can now produce screening strategies.

And then pick your priorities with screening, yes.

Yes. You can look at your treatment plans, you can now look at your palliative care plans. But if you don’t have cancer data, if you don’t have statistics it’s impossible for you to plan. So what we did is the active cancer registry, good national cancer data and scientifically based cancer policies available for all patients and increasing your success.

Murat, thank you for joining us on ecancer.tv.

Thank you.