ESGO 2013
Disparities in ovarian and cervical cancer screening across Europe
Prof Vesna Kesnic - ESGO President Elect
Prevention of cancer is a big issue, of course. There’s primary prevention but also secondary prevention and screening is an important part of that. Can you tell me what kind of contribution you think the European Society of Gynaecological Oncology is making to overall prevention?
Yes, I must tell you that cure and treatment is nice and important but I think for doctors, all of us, prevention is even more of a challenge. So ESGO, our society, realises fully that prevention is an integral part of cancer care and in the future we are really ready to focus on prevention, also as a part of our activities because there are still countries in Europe which even don’t have prevention programmes, they don’t have screening. There is a lot to cover and it is not only cervical cancer, it is ovarian cancer also; this is cancer in general, uterine cancer, we know the real measures that could be done in contribution to prevention in physical activity, nutrition. So there is a big area which we are ready to start addressing.
In fact today we’ve been hearing some very interesting things about screening for ovarian cancer.
It’s an amazing lecture.
And you are interested also in cervical cancer. There are differences, presumably, between Serbia and the West of Europe. What’s happening, what are your plans?
The differences are in general, they exist between Eastern and Western Europe because most of the Western countries have screening introduced for cervical cancer, effective screening, and most of the Eastern countries either have ineffective screening programmes or they don’t have screening programmes at all. So the result is that the rate of incidence and mortality in Western and Eastern Europe, when you look at the map, they are so impressive, the differences that you can almost draw a straight line between West and East in terms of incidence, mortality, lack of screening, lack of awareness. So one of the things I’m sure we have to specifically focus on is awareness; to raise it among women, among doctors also but also among politicians and people who are making decisions about our health.
What do you make of the idea that you should put HPV testing to the front of cervical screening?
Of course, there are countries as the Netherlands where HPV screening already has started so they shifted their screening policies from primary cytology to HPV testing. Then, in the future, it will probably have the result of a longer period between screenings, it probably will be much more cost effective. So this is the model which is probably the better solution for most of the low-income countries which are at the beginning of the process of implementation and screening where cytology is poorly developed. But this is something that we have to work together on at a European level to find out the best screening models and probably in the future to shift to HPV screening, but remember that for HPV screening a lot of money would be needed so it is also related with money, with the budget, with lots of national ministries.
Lots of things, yes. Now, I know in your own work you’re very interested in quality of life and patient advocacy. In just a few seconds can you tell me what’s the scope of ESGO in helping these issues?
Yes. I deeply believe that being a doctor is not just about the knife and the prescriptions, about surgery and medications, that being a doctor presumes that you address the patient as a whole person so there is a body and there is a spirit and this is something that we should never, ever divide. So my own interest in quality of life and communication and patient advocacy is really very deep but also I am happy that ESGO, as a society, has developed a large European network of patient advocacy groups for gynaecological cancer. It’s amazing what this network has done in the last two years so they are part of ESGO activities directly focussed to patient advocacy to help them to establish the local groups, to integrate, to work together, to collaborate.
And in just five seconds, what would you recommend doctors to be doing about all of this, about the advocacy?
Look your patients in the eyes, that would be really my message. We have to regard the patient as a whole person.
Vesna, it’s been nice looking you into the eyes and thanks for joining us on ecancer.tv.
Thank you.
