Innovation should not be a new factor of inequality in cancer care, notes Professor Jean-Paul Vernant in a report submitted to the government.
With 30.5 days as the average waiting time to urgently obtain an appointment for an MRI, the results of the Cancer Plan 2 already pointed out a few days ago the under-equipment in France and the geographical inequalities. And it is precisely these inequalities that the Cancer Plan 3 will mainly tackle. “Attempting to resolve the difficult problems of social inequalities, relations between caregivers and patients and between hospital medicine and city medicine which go far beyond the scope of cancer” it is therefore one of the guidelines clearly displayed in the preamble of the orientation report for the 3th Cancer plan (2014-2018) given to the government on Friday by Prof. Jean Paul Vernant.
Set up inequality indicators
“Cancer in France is the pathology in which health inequalities are very marked compared to other pathologies and compared to other European countries” write the authors of the report. Thus, they propose the establishment of indicators to measure and control these social or geographic inequalities. A reduction that could be followed, for example, by an indicator such as that of premature cancer mortality. On the other hand, these experts believe that the primary prevention of cancer must be significantly rethought, to address, with adapted and effective methods, groups at risk and vulnerable populations. Whether for breast cancer screening or colorectal cancer screening, all the surveys show significant disparities depending on the region, age and socio-economic characteristics. Finally, a final indicator could be that of survival inequalities. Since survival results from care, by better estimating survival, while integrating social and professional data, it would be easier to identify inequalities in care.
Corrective actions
“ Faced with an increasingly important technicality, care should be taken that therapeutic innovations do not provide an opportunity to accentuate the social and territorial inequalities which are already too great, ”explains Professor Vernant. Although he recognizes and welcomes the development and progress of the teams of cancer researchers during the two previous plans, he specifies that it will be necessary to continue collaborations with industrialists in particular so that therapeutic innovations are implemented as quickly as possible. the disposition of the sick. On the other hand, they plead for “the public authorities take their responsibilities and negotiate with the industrialists so that these innovations are marketed at their fair price. On the other hand, the report specifies that access to care continues to pose a problem in our health system, in particular because of excess fees, out-of-pocket expenses (transport costs for example or certain cosmetic costs. ), but also delays in diagnosis or treatment.
Adapt to future developments in real time
Finally, although placed under the sign of the fight against inequalities, the report also proposes two other objectives for this 3th Cancer plan. First of all, it will have to implement the necessary adaptations to the health system and its financing linked to foreseeable changes in the treatment of cancers which require changes in practices, professions and equipment. And for this, the Cancer Plan 3 should rely more on the participation of the attending physician in the care pathway that will take place in the future, largely on an outpatient basis. Finally, the last major objective displayed in this report is that it is now necessary to simplify the current organization in order to increase its efficiency and consistency. For this, the experts recommend, for example, to leave to the Inca all its national responsibilities and to give the canceropoles “broad interregional responsibilities” and to transform the old regional networks “into a regional delegation under the supervision of the canceropoles. ”
For the Ministries of Health and Research, the proposals of Prof. Vernant “ will enrich the important work of the working groups “Set up by the government with INCa to develop the Cancer Plan 3 which will be” announced at the start of 2014 “. Cancer remains the main cause of death in France with 148,000 deaths estimated in 2012 and 355,000 new cases per year, recalls the report.
.
