In Poland, it is estimated that almost 50 percent of patients have visited or will visit an oncologist, cancer surgeon or radiotherapist later than they should. For this reason, the number of deaths as a result of cancer diseases may increase by up to 20%. Lung cancer is the most common malignant neoplasm in Poland and the first cause of cancer deaths, both among women and men. Only about 13,5 percent. Polish lung cancer patients have been living for 5 years since diagnosis.
In response to these challenges, the All.Can Polska initiative prepared a document containing a number of practical tips and specific recommendations on how to do this, also during the COVID-19 pandemic – an expert opinion: “Optimizing the model of financing diagnostic and treatment services in cancer treatment in order to improve patient pathway and maximization of lung cancer treatment outcomes ”. The expertise shows that in order to reduce the incidence and improve the results of lung cancer treatment, it is necessary to more effective primary and secondary prevention, improve the availability and quality of diagnostics, increase access to innovative therapies, and develop a network of comprehensive medical care centers for patients with lung cancer, the so-called . Lung Cancer Units.
“It is necessary to obtain better cooperation between individual centers, to ensure comprehensive procedures and to finance services commensurate with the needs. Patients must be at the heart of the healthcare system. This necessity applies, inter alia, to the management of lung cancer. Time from the onset of symptoms suggestive of neoplasm
It is currently too long to start lung cancer treatment in Poland, and moreover, in a significant proportion of patients, adequate combination therapy is not used. That is why the report, the purpose of which is to indicate a more appropriate model of management and, consequently, to obtain better results in lung cancer treatment, should be an important element in the discussion on the development of optimal solutions in oncological care in Poland “- believes prof. dr hab. n. med. Maciej Krzakowski, head of the Lung and Thoracic Cancer Clinic of the National Institute of Oncology. Maria Skłodowskiej-Curie in Warsaw, National Research Institute, national consultant in the field of clinical oncology.
“In Poland, it is estimated that almost half of the patients visited or will go to the oncologist, cancer surgeon or radiotherapist for the first time later than they should. Consequently, the number of deaths due to cancer may increase by as much as 20%. This is a dramatic situation that requires all countries to develop recovery plans. Their aim should be to restore health systems to at least the level they operated before the pandemic. In Poland, it is extremely important to improve the quality of oncological care, which will allow for better allocation of available resources – for example for the most effective therapies, ”says Szymon Chrostowski, chairman of the Presidium of the All.Can Polska Steering Group, president of the Wygrajmy Zdrowie Foundation.
The basis for the preparation of the report was a systematic review of the literature, data from the Ministry of Health, the National Health Fund, the Agency for Health Technology Assessment and Tariffs, the National Program for Combating Cancer Diseases and the National Oncological Strategy, as well as Polish, European and global guidelines of scientific societies in the field of oncology and treatment of lung cancer.
According to the data of the Ministry of Health, malignant neoplasms of the trachea, bronchi and lungs are the third most serious health problem in Poland, according to the DALY index (an index which is the sum of the number of life years lost due to premature death and the number of years lived with disability). The first two health problems of Poles are ischemic heart disease and strokes. At the same time, cancers of the trachea, bronchi and lungs are responsible for 26 percent. DALY for all cancers, while colorectal cancer for 13 percent and breast cancer for less than 7 percent. Therefore, the prevention and treatment of neoplasms of the bronchi and lungs are crucial from the point of view of the health needs of our population.
Meanwhile, from the beginning of 2020, a crisis in oncological treatment caused by the COVID-19 pandemic has been visible throughout Europe, mainly related to limited access to diagnostics and treatment.
Mainly expert opinion recommendations:
- Among primary health care physicians, the principle should be promoted – first to exclude neoplasm by ordering initial diagnostics.
- The model of coordinated oncological care within the National Oncological Network (KSO) should be implemented without delay.
- In order to improve the effectiveness of lung cancer treatment, it is necessary to introduce a model of comprehensive and coordinated lung cancer care in Poland, the so-called Lung Cancer Units.
- The valuation of diagnostic packages for cancer detection under AOS (Outpatient Specialist Care) should be increased.
- Billing of diagnostics by hospitals should be based on packages.
Test sets should be created, billed as a package, provided that the complete list of tests is performed in accordance with the medical indication. They should also include molecular diagnostics.
- The scope of molecular tests performed in individual neoplasms should be extended in order to adapt the type of therapy to the type of disease, including pathomorphological tests.
- In order to improve pathomorphological and molecular diagnostics, mechanisms should be introduced to ensure full funding and the possibility of performing a full panel of tests in one facility.
- The organization of molecular diagnostics should be changed towards the creation of a network of laboratories linked to the coordinating centers of the National Oncological Network.
- The method of financing the chest image in the AP and lateral projection should be changed from the capitation rate to the pool of benefits financed according to the price of the unit of account.
- Public funding should be restored and the availability of low-dose computed tomography population screening programs improved
- The Ministry of Health should treat staffing needs in oncology as a priority when shaping the policy of creating specialization places for doctors. It is necessary to create such a number of residences that will ensure a stable development of the number of medical staff in specialties crucial for efficient diagnosis and treatment of cancer.
- In order to improve primary prevention, universal and effective primary prevention programs should be developed and funded, relying on large-scale educational programs, especially among young people.
- The Act on the Medical Fund should make it clear that technology can also be a technology of high clinical value and high innovation.
- In order to improve treatment outcomes, access to molecularly targeted and immunocompetent drugs should be significantly expanded.
Expert report “Optimization of the financing model for diagnostic and treatment services
in the treatment of cancer in order to improve the patient’s path and maximize the results of lung cancer treatment ”was inspired by the initiative of All.Can Polska, in cooperation with the Modern Healthcare Institute.
All.Can Polska is an initiative aimed at drawing the attention of the public and decision-makers to the need to improve the effectiveness and stability of oncological care and the situation of patients through the effective use of available financial resources.
The full text of the report is available on the All.Can Polska website:
AllCan Ekspertyza_rak płęka3 (all-can.pl)