Up to 23,000 people die of lung cancer in Poland each year. This is more than for colon, breast and prostate cancer combined. It is one of the worst prognostic cancers. Five-year survival is achieved in only 14.4 percent of patients. Moreover, in the European system, Poland ranks fourth in terms of incidence and second in terms of mortality from the disease. This is because the disease is most often diagnosed too late. Cancer diagnosed at the fourth stage in almost all cases ends in the death of the patient. First stage cancers manage to be cured in 92 percent of cases.
- It's not that our community is taking no action. Together with pulmonologists and thoracic surgeons, we propose numerous solutions. Unfortunately, they mostly remain on paper. These are, in theory, some of the best European solutions. The snag is that when we get down to practice, i.e. the patient pathway, time of diagnosis and implementation of treatment, we find that we are at the gray end. We would like our studies to actually serve patients and be used to organize care, to be the impetus that will improve the prognosis of the disease," said Prof. Rafal Krenke, head of the Department of Internal Medicine, Pneumonology and Allergology at Warsaw Medical University.
Meanwhile, in the context of lung cancer, it appears that it will be difficult to meet even the basic objectives of the National Cancer Strategy. First of all, there is a shortage of people to diagnose and treat patients.
- We have to develop the number of specialists in oncology, but also in related specialties. I regret to say that lung disease departments are being closed because there is a shortage of specialists. We are conducting tobacco disease prevention in Poland, but if we trace the list of centers in individual provinces, I would euphemistically say that it is highly unsatisfactory," Prof. Rafal Krenke mentioned.
It is also worth remembering that lung cancer is not only the result of cigarette smoking. The air we breathe has a not insignificant impact on the development of these diseases.
- Warsaw ranks first internationally in terms of exposure to PM2.5. If we reduced air pollution to WHO standards, we would reduce mortality by 9 percent. And you should know that these standards are not particularly exorbitant. An even greater reduction would reduce mortality by 12 percent, - Prof. Rafal Krenke stressed.
However, it turns out that the implementation of solutions leading to the reduction of low emissions is most often met with strong public opposition. This is the case, for example, with plans to introduce clean transportation zones.
Also of no small importance is the desire to maximize the benefits of secondary prevention. In addition to lung cancer, screening with low-dose computed tomography (NDTK) can detect diseases such as emphysema, cardiovascular disease and interstitial lung disease. Poland's lung cancer screening program was one of the first of its kind in Europe. Unfortunately, its potential is not being used to its full potential.
- The issue of funding is one of the main problems that the program stumbles over. Unfortunately, there should be decent pay for such work, and it should be remembered that the description of a screening test is a major challenge for a radiologist," noted Professor Joanna Chorostowska-Wynimko of the Institute of Tuberculosis and Lung Diseases.
- Awareness of the problems associated with the smooth implementation of screening programs is growing. The European Commission last year allocated 10 million euros to the European program. Poland is one of the main beneficiaries. This is an implementation project. It is not to prove that something works, but to gather experience and create guidelines that will ensure the most effective implementation of the screening program," Prof. Joanna Chorostowska-Wynimko pointed out.
In Poland, however, a sizable problem remains in reaching those targeted by prevention to the center that conducts the study. Still, some regions struggle with communication exclusion.
