Better than screening: with help from WHO, Ukraine chooses cost-effective policy to prevent breast cancer

International Women’s Day (IWD), March 8, is an opportunity to highlight a health problem that affects up to 1 in 10 women in many countries in the European Region – an inspiring story of research by Ukraine the best tool to combat breast cancer. The country’s authorities have used the expertise and advice of WHO / Europe to modify their initial plans for mammography screening nationwide and have started to develop a more promising early diagnosis program. This decision will save Ukraine thousands of lives and millions of euros in loans.

Breast Cancer Prevention: Finding Best Practices

A recent study by IARC and EURO showed that in Ukraine more than one in four breast cancer is diagnosed at an advanced stage, making a cure beyond reach even with the best treatments. To break this worrying trend, Dr Arman Kacharian, head of cancer control at the Ministry of Health of Ukraine, turned to WHO / Europe for its expertise in this area.

In 2019-2020, he discussed effective breast cancer prevention policies at the IARC / WHO Cancer Screening Workshop and the major WHO / Europe Screening Conferences, where he concluded that a large-scale mammography screening program would not be the best option for Ukraine. improve her situation with breast cancer.

According to the latest WHO guidelines, national mammography cancer screening programs tend to be expensive and only show positive results in countries where health systems have vast economic and human resources. The health systems of many countries in the WHO European Region are unable to test large numbers of healthy women and ensure rapid and accurate diagnosis and follow-up of those who test positive.

After consulting with experts from WHO / Europe, Ukrainian authorities turned their attention to another cancer prevention strategy recommended by WHO – the early diagnosis program. It is based on the rapid identification of cancer in patients with symptoms of the disease and rapid and complete follow-up of the diagnosis. Given the major improvements in breast cancer treatment over the past decades, in cases where breast cancer is diagnosed at an early palpable stage, the rates of safe cure are very high.

Early diagnosis program: what are the benefits?

Cancer, when identified early, is more likely to respond to effective treatment, which translates into a greater likelihood of survival as well as less burdensome and less expensive treatment. The value of early detection of cancer is clear and significant improvements can be made in the lives of cancer patients.

“Compared to the mammography screening program, centralizing advanced centers providing high-quality early diagnosis of breast cancer is more efficient, economical and sustainable in a resource-limited environment,” said Dr Olga Trusova, an expert in Belarusian leading mammography who participated in the BELMED project to implement breast cancer screening in Belarus. BELMED has been funded by the EU and implemented by WHO / Europe and IARC since 2016.

WHO / Europe organized a series of online consultations between Dr Kacharian and Dr Trusova to share their views and expertise on cancer prevention policies.

The approach to early diagnosis of breast cancer has been recognized as more appropriate for Ukraine than screening by mammography. It requires fewer resources and allows the Ukrainian health system to better prepare for future screening measures if necessary.

Saving Ukraine’s Resources

WHO / Europe also helped Ukraine assess its resources. The country is collaborating with France on breast cancer prevention projects. In early 2020, France offered Ukraine a reduced rate loan of 24 million euros to purchase mammography machines for screening.

Following expert advice from WHO / Europe, Ukraine carried out a rapid mapping of mammography facilities available in the country by comparing them to national breast cancer detection data stratified by regions, including data from the country. Ukrainian breast cancer screening pilot program.

It turned out that the country had sufficient mammography equipment to launch an effective program for the early diagnosis of breast cancer. It was only necessary to ensure that the existing mammography units were operating at full capacity, treating more than 4-8 women per day, as some are currently doing.

“The help from WHO has saved a lot of money for Ukraine,” said Dr Kacharian, “The concessional loan was for the purchase of mammography units. If we don’t need this equipment, we won’t have to repay the loan. We will renew mammography equipment in specialized oncology hospitals to organize a one-day diagnostic program ”. WHO / Europe is involved in the discussions where Ukraine is currently negotiating with France to see how to invest more effectively in the fight against breast cancer.

About Derrick Hill

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