Turkish Ministry of Health, 2nd Turkish Medical General Assembly Clinical Oncology Study Group Report

Abstract

Objective: There is an increase in the incidence of cancer, and consequently in mortality rates, both in the world and in Turkey. The increase in the incidence and mortality rate of cancer are more prominent in our country as well as in other developing countries. The aim of this workshop was to determine the current status on prevention, screening, early diagnosis and treatment of cancer in our country, to identify related shortcomings, specify solutions and to share these with health system operators, and to aid in implementation of these systems. Developments on palliative care were also evaluated. Materials and Methods: The current situation in the practice of clinical oncology, related drawbacks, problems encountered during multidisciplinary approach and their solutions were discussed under several sub-headings during a 3-day meeting organized by the Turkish Ministry of Health (Türkiye Cumhuriyeti Sağlık Bakanlığı-TCSB) with participation of 16 scientists from Turkey and 6 from abroad, and the conclusions were reported. Results: It is expected that the newly established Turkish Health Institutes Association (Türkiye Sağlık Enstitüleri Başkanlığı-TÜSEB) and the National Cancer Institute (Ulusal Kanser Enstitüsü) will provide a new framework in the field of oncology. The current positive findings include the increase in the number of scientists who carry out successful trials in oncology both in Turkey and abroad, the implementation of the national cancer registry program by the Cancer Control Department and the breast cancer registry program by the Turkish Federation of Breast Diseases Societies (Türkiye Meme Hastalıkları Dernekleri Federasyonu-TMHDF), and introduction of Cancer Early Diagnosis, Screening, and Training Centers (Kanser Erken Tanı, Tarama ve Eğitim Merkezi-KETEM) for the application of community-based cancer screening programs. In addition to these, obvious shortcomings related to education, implementation, management and research issues were also determined, and policy and project proposals to address these issues were presented. Collaboration with relevant organizations in the implementation of these studies was supported. Conclusion: Both the incidence and mortality rates of cancer are increasing in Turkey. The widespread deficiencies in population-based screening and in effective treatment lead to an increase in delay in diagnosis and mortality. Despite improvements in data recording, screening and treatment over the last 10 years, extensive, organized, population-based screening programs and fully equipped early diagnosis and treatment centers are required. Enhancement of basic cancer epidemiologic, translational, genetic and molecular research studies is essential in our country. Improvements on pain treatment and palliative care of patients with chronic and terminal cancer are also required.

The prevelance of human papillomavirus (HPV) genotypes detected by PCR in women with normal and abnormal cervico-vaginal cytology

“…In developed countries where screening activities commonly applied success rates are particularly impressive whereas in developing countries CC still causes significant number of deaths [23]. According to Turkey cancer control programme, CC is the 10 th most frequently observed cancer in women following breast, thyroid, colorectal, uterus corpus, lung, stomach, ovary, non-Hodgkin lymphoma and brain cancers [3]. Although it can be speculated that CC does not represent a serious threat in Turkey compared with other cancers, a global CC screening program with cervical smear test has been applied by department of cancer of Ministry of Health since 1992 [24].…”

“…In accordance with global scientific trends, national screening programme for CC was changed after two decades and HPV testing was implemented as a primary screening for CC [23]. According to the Renewed National Cervical Screening program, HPV test once in 5 years and smear evaluation in HPV positive cases is recommended to every women between ages of 30-65 [3]. In this context, it is important for centers to present their own results to the scientific community and exchange knowledge and practice on preventing CC development.…”

“…There is a large difference in terms of mortality and morbidity rates of CC in developing and developed countries because CC cases have been significantly reduced in developed countries due to the implementation of effective screening programmes [2]. Based on the difficulties in implementing cytology-based screening tools in developing countries like Turkey, the burden of disease remains very high, pointing to the need to engage and educate the broader public on prevention of CC [3].…”

The Prevalence of Human Papillomavirus Genotypes in Women with Abnormal Cervical Cytology

“…Küresel bilimsel eğilimlere uygun olarak, servikal kanser için ulusal tarama programı, 20 yıl sonra değiştirilmiştir ve HPV testi, servikal kanser için birincil tarama olarak uygulanmıştır. Yenilenmiş Ulusal Servikal Tarama programına göre, beş yılda bir HPV testi ve HPV pozitif olgularda smear değerlendirmesi 30-65 yaş arasındaki her kadına önerilmektedir [6,7] . Çalışmamızda anormal sitolojili kadınlarda HR HPV prevalansı %69.8 (n= 37) olarak tespit edilmiştir.…”

Progress in palliative care for cancer in Turkey: a review of the literature

“…Barriers for PC development were discussed in some studies [ 20 , 24 , 34 ]. The major barriers reported by Turkish MoH, 2nd Turkish Medical General Assembly Clinical Oncology Study Group were lack of public and professional awareness, failure of PC planning and disconnection from anticancer treatment, hurdles in the accessibility of opioid analgesics, financial issues and the lack of trained PC providers [ 260 ].…”