Italy and the fight against cancer: the health service promoted but with strong regional differences

(by Nicola Simonetti) About two thirds of citizens and cancer patients satisfied with the assistance offered by the NHS, but with a heavy regional gap, between the top of Lombardy (81%) and Calabria, where one citizen out of three expresses a negative opinion . In Puglia only three out of 10 cancer patients claim to have received diagnosis and treatment in the same facility. This is revealed by a research carried out by Ipsos in collaboration with patient associations and presented at the annual forum of the project "Health: a good to defend, a right to promote" promoted by Salute Donna onlus and by 24 Associations of oncology and cancer patients -ematologici.

In Italy, for the 2019, 371 thousand new cases of cancer are estimated. Currently 3.460.000 people live with a tumor, still the second leading cause of death in our country, but almost half of the citizens still feel poorly informed: in the North and the South only one Italian in two (55%) believes they have enough information. The Italians however, and in particular the cancer patients, are mostly (64%) satisfied with the assistance offered by the Health Service, albeit with strong regional differences: the percentage of positive judgments goes from 81% of the Lombards to 26% of citizens of Calabria, where there is also the peak (36%) of negative judgments. But still one tumor out of three is discovered by chance and only 6% is evidenced by a screening control offered by the NHS, and also here with significant regional differences, from the 9% of Lombardy to the 2% of Calabria.

«We need to implement palliative care networks, including pediatric ones, to give dignity to the sick until the end. The oncological networks are present only in nine regions while the new organizational guidelines have been activated to favor the homogeneous development of the networks throughout the national territory and I hope that soon a central coordination of the networks by the Ministry of Health will be activated to speed up the embodiment. I would however like to stress that in Europe we are the country with the highest survival five years after the diagnosis of cancer (Deputy Minister of Health Pierpaolo Sileri).

In a sign of a new phase in the relations between Patient Associations and the political world, during the Forum the winners of the first edition of the Cancer Policy Award were announced, an honorary award given to politicians who have interpreted and translated Acts at national and regional level. qualifying points of the Legislative Agreement signed by the Patient Associations with the Institutions.

"The project" Health: a good to defend, a right to promote "was launched 5 years ago with the aim of eliminating disparities and differences in cancer care at the regional level, urging the policy to intervene. The results of the research - said Annamaria Mancuso, President of the Donna Salute onlus - say that we still have a lot of work to do, all together, to improve information, waiting times, protecting the rights of cancer patients. From this path, the Legislative Agreement signed by the whole Parliament is a fundamental element and through the Cancer Policy Award we wanted to point out the political exponents who are working to achieve it ".

Satisfaction levels for the structural elements of the treatment path highlight the regional differences between North-Central and South (with the partial exception of Sicily): approximately 64% are Lombard patients satisfied with the quality of the hospitalization department, while those of Sardinia and Calabria express a positive judgment, respectively, only in 40% and in 41% of cases.

The concentration of Centers of Excellence in the Lombardy area is recognized by 83% of patients interviewed in the region, while Calabria sins both due to the availability of this specific offer (known only to 35% of cancer patients), but also for what concerns oncology surgery (34%).

The quality of the human element instead puts the oncology patients of all the monitored Regions in agreement: both as regards the ability to put the patient at ease (courtesy and empathy), and as regards the recognition of professionalism, doctors and Calabrese nurses (7 on 10 the satisfied) have nothing to envy to Lombard (76%) or Sardinian (72%).

Levels of satisfaction due to the presence of multidisciplinary teams that take care of the patient are less homogeneous: ranging from the minimum of 35% satisfaction expressed by Sardinian patients, through the 59% of Sicilians at most in Lazio, with 73% of satisfied patients for this service.

Finally, information on genetic tests, innovative drugs and the presence of Breast Units, which have low levels of notoriety both among citizens and patients, need to be improved: only 43% of citizens and 51% of patients are at current of the tests which can be accessed to map the genetic predisposition to the disease, the 47% of the citizens and the 61% of patients know about the innovative drugs dedicated to cancer care and even more limited the knowledge of the multidisciplinary Senology Centers, the so-called Breast Unit, known only to a little more than a citizen on 3 and equally to patients.

«The awards of the Cancer Policy Award are intended as an invitation to the various political groups to work together to adopt useful measures for better patient care. We trust that - declares Annamaria Mancuso - the partnership with the Institutions will help us to overcome the disparities and inhomogeneities of care-therapeutic and social that involve patients with cancer ".

All CancerPolicy Award winners will be invited to share their experiences and mutually support initiatives at parliamentary or regional council level. The goal is to create a virtuous circle that brings together all stakeholders in a transparent way to define organizational models that put the patient's care in charge and the reduction of regional differences in the first place.

Italy and the fight against cancer: the health service promoted but with strong regional differences

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