All.Can Poland publication of report “Diagnosis of changes in oncological care in 2022” – January 2023

Diagnosis of changes in oncological care in Poland

Periodically published document “Diagnosis of changes in care oncology” is a collection of information on systemic changes implemented in Poland in the field of oncology basing on 5 areas defined by experts in the report “All.Can: improving effectiveness and stability of oncological care – recommendations for Poland” published in 2017. They are the result of implementing long-term strategies aimed at improving care (e.g. implementing the concept of the National Oncology Network), but also improving operational functionality (e.g. by implementing new technologies). Being a platform for dialogue, All.Can has the ambition to stimulate change by providing expertise and experience represented by a group of committed experts.

Diagnosis of changes in oncological care in Poland 2022

As in previous years, All.Can Polska undertook to analyze the changes that have taken place in the field of oncological care in 2022 basing on 5 areas defined by experts in the report “All.Can: improving effectiveness and stability of oncological care – recommendations for Poland” published in 2017. The All.Can Polska Steering Committee pointed both the achievements and unmet needs and challenges that require actions in order to improve stability and efficiency of oncological care in Poland. We are glad that in the gathered activities of 2022, we can refer to the most important areas of expected changes indicated by All.Can Polska.

Below there are examples of information presented in the report.

More efficient allocation of available resources for oncological care

• Implemented prevention programs:

1. Expanding access to comprehensive care a beneficiary with breast cancer – the operation of Breast Cancer Units in 31 centers.
2. Increasing the number of centers to 36 (as of December 2022) providing comprehensive care services oncology on a patient with colorectal cancer (Colorectal Cancer Unit).

• Challenges and needs:

1. Threat of unavailability of palliative care oncology patients (87% of those treated palliatively are cancer patients) due to lack of funding or low level of financing services in this area,
2. Increasing the number of oncology classes for medical students in the study program at medical universities

 Increasing the role of primary prevention and screening

• Implemented prevention programs:

1. Breast cancer prevention program including mammography screening of women aged 50-69.In the event of an abnormal mammography result, the program provides further diagnostics: complementary mammography or ultrasound and biopsy of the lesion with histopathological examination.It is financed by the National Health Fund as part of preventive programs in accordance with the actual performance.
2. National Program for Early Detection of Lung Cancer with low-dose computed tomography coordinated and carried out in 16 centers (all provinces).People are eligible for the program aged 55–74, heavy smokers, with consumption tobacco greater than or equal to 20 pack-years, (smoking a pack cigarettes a day for 20 years or 2 packs a day for 10 years) and who have failed to quit smoking for more than 15 years (regarding the last period of abstinence).

• Challenges and needs:

1. Increasing the effectiveness of invitations to screening tests by introducing various forms communication, including the use of communication with patients via the Patient Online Account.
2. Introduction of changes in eligibility criteria for patients in the National Early Cancer Detection Program Lungs (in particular, lowering the age to 45 years, risk environmental and family burdens).

Providing faster and wider access to innovative solutions medical technology

• Implemented systemic solutions:

1. In the treatment program for patients with hepatocellular carcinoma, combined therapy (immunotherapy) was introduced in the first line of treatment The current scope of treatment as part of the second line was also extended about the possibility of applying after the previous ineffective or not tolerated treatment with tyrosine kinase inhibitors or immunotherapy in combination with anti-angiogenic therapy.
2. The program “Treatment of patients with ovarian cancer, cancer of the fallopian tubes
   or cancer of the peritoneum” specified a maximum initiation of maintenance treatment with PARP inhibitors patients with poorly differentiated ovarian cancer, carcinoma of the fallopian tube or primary peritoneal cancer with the presence of BRCA1/2 mutations
   or regardless of the presence of the mutation in BRCA 1/2 genes

• Challenges and needs:

1. Introduction by the Ministry of Health of an accelerated procedure for reimbursement applications for oncological therapies.
2. Unification of drug programs for individual patients cancers (e.g. lung cancer, breast cancer, etc.).

Taking the patients’ perspective into account in all decisions related to the process of planning, implementing and assessing care oncology

• Implemented systemic solutions:

1. Appointment in 2022 of the Patient Organization Council at Minister of Health as a permanent body consisting of 15 representatives of patient organizations (including 5 representing organizations of patients with oncological diseases), whose task is to conduct a dialogue on systemic issues in health care and exchange views on issues that are most important from the patient’s point of view.The Patient Organization Council is an auxiliary and advisory body in the field of dialogue on matters systems in health care.
2. In 2020, the Patients Ombudsman appointed the Council of Patient Organizations (ROP).The Council is the Commissioner’s consultative and advisory body in the scope of defining areas of threats to the functioning of the health care system, expressing positions on matters presented by the Patients Ombudsman, including in the field of draft legal acts, support for the Patients Ombudsman in the activities related to education and promotion in the field of rights patient.As part of the ROP, which is composed of 91 organizations patients, the Oncology Team was appointed.

• Challenges and needs:

1. Formal empowerment of patient organizations in giving opinions as part of the Council at the Minister of Health and legitimacy reimbursement of new medical technologies.
2. Introduction to the Oncology Council at the Ministry of Health representative of hemato-oncology organizations.

Improvement of patients’ access to clinical trials

• Implemented systemic solutions:

1. Establishment of the Polish Clinical Trials Network in 2021 in order to implement uniform system ones quality and process solutions in entities carrying out clinical trials in Poland.
2. Allocation of PLN 2 billion for research within the Agency’s budget Medical Research

• Challenges and needs:

1. Creation of a central, regularly updated and publicly available registry of clinical trials in Poland, which will inform about the potential opportunities to participate in the study.
2. Disseminating information on ongoing and planned clinical trials among patients and Doctors.

You can find the report here