New approaches in the prevention and therapy of common cancers

Cancer is a leading cause of morbidity and mortality worldwide, with approximately 14 million new cases in 2012 (WHO data) and the number of new cases expected to rise by 70% over the next 2 decades. Cancer is the 2nd leading cause of death - 8.8 mil deaths in 2015 with 774k deaths due to colorectal cancer. Cervical cancer is the 2nd most common type of cancer in women worldwide, more than 90% of deaths occuring in women living in low and middle-income countries. At regional level, official data show that serious efforts must be made to tackle this problem. According to 2012 EU data, cancer is an important common territorial problem for the 2 counties in the project: the Southern Great Plain region in HU (of which Csongrad is part) and the West Region in RO (of which Timis is part) are in the top 2 categories for cancer mortality: SGP region – over 290 deaths/100k inh and W region – 260-290 deaths. The 2016 health report of Timis Public Health Depart: the incidence for colorectal cancer is 36.68 per 100k inhab (the 2nd place in the county), and the rate for cervical cancer is 15.58 per 100k inhab. Some progress was made and the incidence of colorectal and cervical cancer have somewhat diminished in the past years; according to an analysis of hospitalized people in LP, 605 pers were hospitalized due to cervical cancer in 2015, a no. that decreased to 583 pers in 2017 and 1661 pers were hospitalized with colorectal cancer in 2015 vs 1186 pers in 2017. PP1 statistics PP1 show that in Csongrad the incidence of cervical cancer in 2011 was 57, slightly decreasing in 2013 – 53 and the incidence of colorectal cancer was more than triple with 194 cases in 2011, decreasing to 177 in 2013). The 2 counties are still confronting with high numbers of col. and cerv. cancer cases and higher demand for modern and effective healthcare services to improve both screening and prevention on one side, and diagnosis and treatment on the other. Main overall objective: Improving healthcare services in 3 healthcare institutions in Timis and Csongrad counties for prevention, diagnosis and treatment of cervical and colorectal cancer for the benefit of the population of the Timis-Csongrad area in an inclusive and modern approach. The partnership of the project consists of 3 of the most important medical institutions in the Timis-Csongrad area. Acording to Eurostat, in December 2003 a Council Recommendation on cancer screening was adopted, setting out principles of best practice in the early detection of cancer. This invited EU Member States to take common action to implement national population-based screening programmes for breast, cervical and colorectal cancer, with appropriate quality assurance at all levels. The project addresses exactly this need by ensuring access for the population in the 2 counties to modern prevention and therapy techniques of cervical and colorectal cancer with modern medical equipment in 3 medical facilities at the cross-border area of Timis-Csongrad (5 depart. in Timis and 2 in Csongrad). The project will create a network of improved healthcare services across the area of the project through joint cross-border actions that will facilitate awareness for the population, knowledge transfer and medical staff competences, joint consultation of pacients and joint protocols. All of these will strenghten collaboration between the 3 healthcare institutions for the benefit of the pop. in Timis-Csongrad. Specific Objective 1: Improving health-care infrastructure for prevention, diagnosis and treatment of cervical and colorectal cancer at 3 health-care institutions in the Timis-Csongrad. Specific Objective 2: Improving access of the population in the Timis-Csongrad area to information regarding health and to quality medical services for prevention, diagnosis and treatment of cervical and colorectal cancer. Main results: -improved healthcare infrastructure for prevention, diagnosis and treatment of cervical and colorectal cancer (SO1), -improved access of the population in the project area to information regarding health and to quality medical services for prevention, diagnosis and treatment of cervical and colorectal cancer (SO2). Output indicator targets: -9/a2 No. of health-care departments affected by modernized equipment. Project target value: 7 depart. (18.42% of target value for the 9/a2 output indicator (38), 116.67% of target value for this call (6)), -9/a1 Pop. having access to improved health services. Project target value: 1,104,406 persons (28.23% of target value for 9/a1 output indicator (3,911,505 persons) and 182.16% of target value set for this call (606,283)). The proportionality ratio of the project is in the highest category as mentioned in the quality assesement grid (more than 90%). Main outputs: -11 medical equipments for cervical and colorectal cancer (CCC) in 7 healthcare depart., -Improved competences for 40 medical staff in CCC, -At least 10000 people better informed on prevention and diagnosis of CCC, -At least 300 people with a better awereness on lifestyle and the risk of CCC, -Effective knowledge transfer on CCC, -2600 people benefiting from improved health services through screening. The project contributes to the “Population having access to improved health services” environmental indicator. The project proposes a new, more innovative approach that addresses cervical and colorectal cancer in an integrated manner tackling it from both preventive and therapeutical points of view and also from both infrastructure and know-how points of view. The project builds on relevant past experience of the partners (and of other organizations) in tackling the cancer challenge. All partners had projects that addressed the need for better infrastructure and equipment, for improved medical staff competences or more efficient knowledge transfer, but the integrated way this project approaches the medical problem is innovative, inclusive and modern and set to ensure a more coordinated effort and more visible improvements of healthcare services and access of population to specific medical care for the 2 types of cancer that the project addresses. Simplified action plan: - purchase equipment; - joint workshops; - promotional actions; - awareness forums;- knowledge transfer; - screening activities. In the 2 counties that form the project area some progress has been made & deaths related to cancer have somewhat diminished in the past years, but the 2 counties are still confronting with high numbers of colorectal and cervical cancer cases & higher demand for modern, effective and improved healthcare services&infrastructure related to these types of cancer. Thus, an inclusive and modern approach is needed and the project responds completely to the constraints and needs of the 2 counties. The cross-border approach proposed by the project ensures a more-effective response to the common challenges that the 2 counties (and countries) face in this matter.

Achieved: 1) Improved health-care infrastructure for prevention, diagnosis, and treatment of cervical and colorectal cancer at 7 health-care departments from 3 institutions in Timis and Csongrád-Csanád county. 2) Improved competencies for 40 medical staff of Csongrád-Csanád and Timis counties in screening, diagnosis, and treatment of colorectal and cervical cancers. 3) Increased awareness of health and prevention of cervical and colorectal cancer through brochures (10000 copies) disseminated to persons from Timis and Csongrád-Csanád county and the through awareness forums organized. 4) Improved access of the population in the Timis-Csongrád-Csanád area to information regarding health and quality medical services for prevention, diagnosis, and treatment of cervical and colorectal cancer. Finalized: 1) Modern equipment purchased for 7 health care departments of the Emergency Clinical County Hospital Timis (2), of the University of Szeged (2), and Emergency Municipal Clinical Hospital Timisoara (2) - a CT device, a Video endoscopy Kit, a 3D Full HD system for laparoscopic endoscopic surgery, a Plasma sterilizer, an ergonomic microscope, a Rotary microtome with manual operation, a High energy linear accelerator, a Treatment Planning System compatible with the existing radiotherapy system, a Software upgrade for the existing linear accelerator, an Advanced imaging license (Stand-alone), two colonoscopes and a Digestive Video endoscopy system with accessories (with 2 video-colonoscopes). 2) 4 joint workshops organized in Szeged and Timisoara on cervical and colorectal cancer for the medical staff from Csongrád-Csanád and Timis counties. 3) 10,000 brochures were elaborated and disseminated to the persons from Timis and Csongrád-Csanád county to inform them about a healthy lifestyle and prevention of cervical and colorectal cancer; 4) 5 awareness forums organized in Timis and Csongrád-Csanád county for the general public (at least 250 pers) on a specific topic related to lifestyle, risk of cancer, prevention, and one health-themed TV broadcast focused also on healthy lifestyle and the risk of cancer; 5) Screening activities free of charge performed on colorectal cancer and cervical cancer for the population in the Timis and Csongrád-Csanád county (more than 2500 persons); 6) 2 medical protocols concluded on screening, diagnosis, and treatment of cervical and colorectal cancers; 7) 16 cases of cervical/colorectal cancer diagnosis and treatment procedures discussed by the medical experts of the three partners, making the treatment of cross-border patients more effective.

The Methodology for defining result indicators (annex to Ro-Hu Programme) sets some of the conditions that need to be in place to ensure improved preventive and curative health-care services (measured through the mentioned programme result indicator): 1.Basic diagnostic and curative equipment, having sufficient capacity and up to appropriate technological standards; 2.Specialized diagnostic and curative equipment, having sufficient capacity and up to appropriate technological standards; 3.Professional and support staff, with proper capacity and appropriate level of training. Main results and outputs of the project: Main result 1 (see SO1): improved healthcare infrastructure for prevention, diagnosis and treatment of cervical and colorectal cancer. Important output indicator targets for SO1: -7 departments affected by modernized equipment. Main result 1 and outputs for SO1 adresses conditions 1, 2. Main result 2 (see SO2): improved access of the population in the project area to information regarding health and to quality medical services for prevention, diagnosis and treatment of cervical and colorectal cancer. Important output indicator targets for SO2: -7 departments affected by modernized equipment. - 1104406 people having access to improved health services (by having access to improved healthcare infrastructure and better care services provided by proffesionals working and being trained together in order to provide better services for the people in the official service area of the medical facilities). Main result 2 and outputs for SO2 adresses conditions 1,2, 3. The project, its results and outputs link directly to the programme result indicator (average service level in health care institutions in the eligible area) as they ensure better services related to cancer for the patients and will contribute directly to the achievement of the target value for the indicator: 3.40 (2023) as set by the programme that will be determined by surveys among hospitals.