New offers bring more hope for 2024

This announcement came about a year ago from the Minister of Health, Manuel Pizarro, who confirmed that in 2023 there will be screening projects that will be implemented for three types of cancer of interest to specialists and Portuguese: lung, prostate and stomach. The European goal is for the new screening program to begin implementation by 2025, but although Portugal is not the only EU country still preparing to implement these methodologies, expectations have not been met within the time announced by the Authority.

However, there is new information that brings some encouragement and hope to the medical community and society in general, as last November the expansion of oncology screening programs to include the three cancers already mentioned was included in the state budget for 2024 (OE 2024), through a proposal to change the PS.

“The inclusion of the three new offerings at OE 2024 is excellent news, and I hope it will come to fruition,” says Isabel Magalhães. The President of Pulmonale – the Portuguese Association Against Lung Cancer has, over the last few years, made contacts with the relevant authorities to implement lung cancer screening, as this is the malignancy that kills the most in Portugal and throughout the world. The expert states that “despite the recommendations of the European Commission in this regard, and despite the minister’s announcement of moving forward with a pilot project later this year, nothing has happened,” stressing that the delay in implementing the examination has an “unacceptable” cost to citizens.

Under the same proposal, over the next year the government will also develop measures to improve the National Tumor Registry, an essential means of integrating information to respond to oncology needs. Strengthening adherence and coverage of existing screening programs for breast, cervical and colorectal cancer is another criteria included in the proposed change.

At this moment, screening is already “coming to the doors of more people,” says José Dinis, director of the National Program for Oncology, citing the example of breast cancer screening, for which “people who are eligible, from North to South, receive the message at home” to take the exam. , the specialist guarantees.

Lung: Screening reduces deaths by 20%

For some types of cancer, screening is a powerful diagnostic tool. Lung cancer is no exception to this evidence, and studies conducted to determine the effectiveness of screening show that deaths associated with this tumor are reduced by at least 20%.

“Lung cancer screening is performed using low-dose CT scan,” explains the head of Pulmonale. When a disease is suspected, additional tests determined by the medical team must be performed.

Screening is indicated for the group of people at highest risk, taking into account age (50-75 years) and high smoking rate in current smokers or in people who have been former smokers for less than 15 years. People exposed to prolonged exposure to certain carcinogens or who suffer from certain pre-existing diseases may also be included. “It should be noted that the screening test will also allow us to find results related to other diseases, whether pulmonary or cardiac,” points out Isabel Magalhães.

Cancer is increasing in women

Lung cancer is a largely preventable disease, with about 85% of cases occurring in smokers or former smokers. “Women started smoking late, which is reflected in an increased incidence of lung cancer,” the specialist says, noting that there is a large time gap between the act of smoking and the appearance of the disease.

However, there are cases of lung cancer that appear in non-smokers and can be caused by other risk factors, such as long-term exposure to certain substances (such as radon or asbestos), or pre-existing health problems that increase the symptoms of lung cancer. This disease, and last but not least, environmental pollution, which has worsened, especially in major cities.

As for the main symptoms, experts highlight persistent or bloody cough, shortness of breath, chest pain or discomfort, recurrent respiratory infections, hoarseness, fatigue, and weight loss.

However, many of these signs are incidental to other diseases or correspond to a worsening of pre-existing symptoms in smokers, sometimes leading to their underestimation. Moreover, the symptoms “are often mild or even absent in the first phase of the disease,” explains Isabel Magalhães, which is why – due to illiteracy and lack of response to the first symptoms – “population screening is of particular importance.”