Conference focus and topics

Pavel Poc, Member of the European Parliament
Ladislav Dušek, Masaryk University, Institute of Biostatistics and Analyses

Dear participants of the 3rd European Colorectal Cancer Days, dear colleagues, friends,

the ambitious aim of the upcoming 3rd ECCDs conference is to continue in a recently established tradition of these spring international meetings focused on one of the biggest problems in European health care, the issue of colorectal cancer (CRC). Unfortunately, incidence and mortality rates remain the same in comparison with previous years; in fact, they are not expected to change dramatically over the next one or two years. CRC remains to be the most commonly diagnosed cancer and the second most common cause of cancer deaths in Europe. More than 200,000 Europeans die each year from malignant tumours of the colon and rectum. However, many of these deaths could be avoided, because CRC is a fully preventable disease. Effective prevention, standardisation and scientifically driven promotion of the CRC screening were among the main topics of the previous two ECCD conferences held in 2012 and 2013 in Brno, Czech Republic. The highly constructive atmosphere, inspiring discussions and outcomes of the previous meeting challenged us to continue in this networking activity in 2014. That is why we would like to announce the 3rd ECCDs event, which will be held from 25th to 26th April 2014 in Brno, Czech Republic. All participants interested or involved in CRC issues are cordially invited.

Outcomes of the previous ECCDs meetings have been published at www.crcprevention.eu. These past events were primarily focused on experience sharing and networking among European countries with respect to the standardisation of colorectal cancer screening. Apart from collaboration and networking, the most common keywords of lectures included standardisation as a necessary solution to the heterogeneity in quality assurance and quality control systems in rather different national CRC screening programmes. The most important executive outcome was in full accordance with the European guidelines for CRC screening, which were published in 2010 and recommended the transformation from an “opportunistic CRC screening” to a “population-based CRC screening”.

Therefore, the topic of CRC prevention and screening is not new. Nowadays, we have very powerful tools for an early detection of this disease, with a big potential to reduce both incidence and mortality rates. Organised cancer prevention has been repeatedly emphasised and declared as an obligatory component of modern health care systems and policies. Scientific evaluations have provided clear results as well; it has been widely published in clinical trials and official guidelines that CRC screening really does have the potential to prevent colorectal cancer and to save lives. The content of the upcoming 3rd ECCD event is designed to contribute to an already shared knowledge in the following areas:

1. Effectiveness of prevention: value of CRC screening – is it worth considering? Why are we still lacking a comprehensive and widespread information support on this monetary as well as ethical dimension of CRC prevention?
2. Harmonisation in reporting: how to effectively communicate and share various designs of CRC prevention programmes and their outcomes in different countries?
3. Convincing promotion: what is the best model to promote population-based CRC screening, including call-recall systems? How to utilise data for an effective communication and “image-making promotion” of the CRC prevention in order to attract the attention of target population?

From the viewpoint of population-based screening programmes, the word “effectiveness” can be translated in two principal modes, which are more or less related to the information basis and communication. Firstly, any population-based health intervention cannot be successful without citizens (or clients) attending the programme and the proposed examinations. The effectiveness of communication addressing target groups is undoubtedly one of the most important elements contributing to a good screening performance and a high population coverage. Secondly, well organised screening cannot reach remarkable outcomes without the support of health care management and payers. The previously proved cost-effectiveness as well as the safety of such interventions is a legitimate claim, which must be addressed and reliably substantiated. A screening programme always represents some kind of investment, and its value and recoverability must be communicated in a convincing way.

Effectiveness is also very closely related to sustainability. Only sustainable health programmes can be effective, and vice versa. Sustainability of any prevention programme certainly does not mean an endless financial support; it also has to include a well-optimised logistics as well as capacity of the system responsible for the diagnostics of patients, and the subsequent care for those who were diagnosed positively. Recent Europe-wide studies, mainly the EUROCARE-5 project, have documented significantly improved survival times of cancer patients in almost all European countries. Rising numbers of survivors represent a new challenge in the fields of proper health care accessibility and quality, risk of multiple cancers and tertiary prevention. To some exent, these aspects should be also considered when designing nationwide population-based intervention programmes.

Many European countries have recently implemented CRC screening programmes . However, the heterogeneity in both design and content of various prevention strategies in different countries is still significant, which inevitably makes the analyses focused on screening effectiveness very difficult. Evidence-based data, scientific calculation background, feedback analyses, effective communication and publishing should be harmonised and supported in this field. That is why we prepared the third year of the ECCD conference to be focused mainly on the value and effectiveness of CRC prevention and screening.

We hope that the third meeting of stakeholders supported by representatives of medical societies and patients’ organisations will again offer a functional platform and a stimulating atmosphere for fruitful discussions about all of these problems and many other related issues.

On behalf of the Programme and Organizing Committees

Pavel Poc & Ladislav Dušek