The incidence of cancers of the haematopoietic and lymphatic systems has increased over the last three decades. However, some patients have limited access to effective treatment. All because selected hemat-oncological diseases are not included in the reports of the National He alth Fund and the Social Insurance Institution, and even in the oncology package, argued specialists during the conference "Advances and challenges in hemat-oncology in Poland."
The incidence ofcancers of the hematopoietic systemandof the lymphatic systemhas increased more than 2 times over the last three decades. It is mainly related to the aging of the society - said Dr. Gryglewicz, a he alth expert from the Lazarski University. If the tendency of life extension continues, the number of people suffering from hemato-oncological diseases will continue to increase - he added. However, some patients have limited access to effective treatment. This applies to patients struggling with, inter alia, with myelodysplastic syndromes and certain myeloproliferative neoplasms, such as myelofibrosis (bone marrow fibrosis), polycythemia vera, essential thrombocythemia and chronic monocytic leukemia.
These diseases are not included in the reports of the National He alth Fund and the Social Insurance Institution. Additionally, many of them are not included in the oncology package. All because of the International Statistical Classification of Diseases and He alth Problems ICD-10, which has not been updated for many years. - If the disease does not have a well-assigned ICD10 code, it is invisible in the financial, he alth and social security systems, which causes a number of problems and complicates the treatment of patients - said Dr. Jerzy Gryglewicz. For this reason, doctors who want to settle the benefits provided to patients with these diseases must classify them as other disease entities included in the package, he added.
ImportantThe International Statistical Classification of Diseases and He alth Problems ICD-10 is - in short - a list of disease entities that are treated in specialist clinics. Each of the diseases on this list has a code, for example myeloid leukemia is C92 and nodular non-Hodgkin's lymphoma is C-82. When issuing a referral, the doctor must provide the name of the disease and its code according to this classification.
The problem is that the classificationthis one is 15 years old. During this time - thanks to the development of medicine, including molecular diagnostics - many disease entities, including hemato-oncological ones, have arisen. They are not on this list, which causes problems in treating patients. A disease that does not have its own code is invisible in the he alth system.
However, these are not the only problems in Polish hematology. In 2014, there were 411 hematologists in Poland. This means that per 100,000 inhabitants had 1.3 specialists, which placed Poland among the EU countries with the lowest rate of hematologists per 100 thousand. residents. In this respect, we are ahead of such countries as Bulgaria (4.5 hematologists per 100,000 inhabitants) or Lithuania (3.0 hematologists per 100,000 inhabitants).
In addition, access to many new methods of treating hematological cancers is difficult. In Poland, the implementation of a new drug program takes years, said prof. Andrzej Hellmann from the Medical University of Gdańsk. And that's way too long.
Blood cancers - recommendations of specialists
Specialists have developed a number of recommendations aimed at improving the availability and quality of treatment for patients with blood cancer. First of all, it is necessary to implement the new international classification of diseases ICD-11, currently being developed by the World He alth Organization.
An additional problem was that the oncological package did not include many hemato-oncological diseases […] therefore the recent decision of the Minister of He alth to include new hematopoietic and lymphatic system diseases in the amendment of the oncological package should be assessed positively.
In turn, prof. Hellman proposes to restore treatment options as part of the custom chemotherapy program, which ceased to function on January 1, 2015.
Cancer of the blood - survival of patients improves
The good news is that in the first decade of the 21st century, there is an improvement in 5-year survival among patients with hematopoietic and lymphatic neoplasms, i.e. from 43.1 percent. up to 45.9 percent in men and with 44.6 percent. up to 48.7 percent in women. This is the result of, among others better organization of hematological care - argues prof. Dariusz Wołowiec, national consultant in the field of hematology.
This will be useful to youIn the last 30 years, the number of new cases of cancer of the haematopoietic and lymphatic systems has increased more than 2 times. In 1990, the crude incidence rate was 8.8 / 100,000 inhabitants (10.4 in men and 7.4 in women), and in 2010 - 16.8 / 100,000 inhabitants (18.1 in men and 15.5 in women).
With the age of patients, an increase in the incidence of hematopoietic and lymphatic neoplasms is observed - most cases are recorded between the ages of 50 and 79 (about 60%)
The risk of developing hematological neoplasms among children and young adults remains at the level of about 6 / 100,000, while after the age of 50 it increases with age.
The frequency of deaths from hematological cancers in Poland is 4.5%. in men and 4.9 percent. in women. Most of them occur between the ages of 70 and 79 (about 1/3 of deaths).
Treatment for this type of cancer varies depending on the diagnosis. In acute leukemias, the disease progresses rapidly and, if left untreated, leads to death within weeks / months. In this case, radical treatment is used to cure the patient. In myeloproliferative tumors, especially in the absence of a Ph chromosome, disease progression is slow, but the tumors are incurable. In this case, palliative treatment is implemented.
Source:Report "Oncological hematology - clinical, economic and systemic aspects",prepared by experts from the Institute of He althcare Management at the Lazarski University in Warsaw.