Cervical Cancer Screening: Defining the Need for Research.

Abstract:

:With the development of a National Cancer Plan published in 2012, Germany has followed the recommendations of the WHO and the EU. The first area of action listed in Germany's National Cancer Plan is improving the early detection of cancer. Both citizens and medical specialists are encouraged to take responsibility themselves and contribute to the efforts being made to meet the challenge of cancer. Screening for cervical cancer has long been an integral part of the German Directive for the Early Detection of Cancer and now - following the recommendations given in the European Guideline - an organised screening approach shall be developed to maximise the benefits and minimise the risks through a partial reorganisation of existing structures. Before this can be rolled out nationwide, it will be necessary to check the feasibility and suitability of new contents and organisational structures. The Federal Joint Committee which is largely responsible for the process according to the draft law on the implementation of the National Cancer Plan has emphasised the importance of evidence-based medicine and of collaboration between the autonomous governing bodies within the healthcare system to obtain viable results. For medical specialists, the follow-on question is which areas will need more research in future. New process steps need to be developed and verified to see whether they offer evidence which will support defined approaches or whether such evidence needs to be newly compiled, e.g. by testing invitation procedures for screening in trial schemes. The experience gained during the implementation of the existing directive on early detection of cancer should be integrated into the new process. Research initiated by specialists could encourage the development of a new version of the Directive for the Early Detection of Cancer suitable for the Germany's healthcare system. ZUSAMMENFASSUNG:Mit der Entwicklung des 2012 veröffentlichten Nationalen Krebsplans folgte Deutschland den Empfehlungen von WHO und EU. An erster Stelle der Handlungsfelder im Nationalen Krebsplan steht die Weiterentwicklung der Krebsfrüherkennung. Bürger/-innen sind zur selbstverantwortlichen Beteiligung an den Anstrengungen zur Bewältigung der Herausforderung Krebserkrankung ebenso aufgefordert wie die Expert/-innen. Die Früherkennung beim Zervixkarzinom ist seit Langem Bestandteil der Krebsfrüherkennungsrichtlinie und soll nun – unter Berücksichtigung der Europäischen Leitlinien – zu einem organisierten Screening weiterentwickelt, mit der teilweisen Neuorganisation der Nutzen maximiert und die Risiken minimiert werden. Vor einer flächendeckenden Implementierung ist es nötig, neue Inhalte und Organisationsstrukturen auf Machbarkeit und Eignung zu prüfen. Der Gemeinsame Bundesausschuss, in diesem Prozess nach dem Gesetzentwurf zur Umsetzung des Krebsplans führend, betont die Bedeutung der evidenzbasierten Medizin und das konkrete Zusammenwirken der Selbstverwaltungspartner für die Ergebnisfindung. Im Fachgebiet ergibt sich daran anknüpfend die Frage nach anstehendem Forschungsbedarf. Neu auszugestaltende Prozessschritte sind zu überprüfen, ob Belege für eine definierte Vorgehensweise bestehen oder erarbeitet werden müssen, z. B. das Einladungsverfahren in einer Erprobungsregelung. Die Erfahrungen aus der Umsetzung der bestehenden Früherkennungsrichtlinie sollen dabei einfließen. Eine aus dem Fachgebiet heraus initiierte Forschung könnte mit ärztlicher Kompetenz den Prozess hin zu einer für das deutsche Gesundheitssystem geeigneten Neufassung der Krebsfrüherkennungsrichtlinie fördern.

authors

Simoes E,Brucker S,Beckmann MW,Ortmann O,Albring C,Wallwiener D

doi

10.1055/s-0032-1328303

subject

Has Abstract

pub_date

2013-03-01 00:00:00

pages

239-246

issue

3

eissn

0016-5751

issn

1438-8804

journal_volume

73

pub_type

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