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Ben RHM II - LZG.NRW

Ben RHM II - LZG.NRW

Benchmarking Regional Health Management II (Ben RHM II) ___________________________________________________________________________________________________________________________________________________________________ women in the age group 40-64 years. The HSO further developed the programme and ex- tended it to more regions and prefectures, including one more prefecture in Western Greece (Aitoloakarnania). The following programme description mainly refers to the Greece Against Cancer programme, which is run similarly to its predecessor programme, Europe Against Cancer. Organisation of programmes The Hellenic Society of Oncology and the Hellenic Anti-Cancer Institute carried out the Europe against Cancer programme and are now running the Greece Against Cancer programme. They have formed an organisation called the Hellenic Foundation of Oncology, which organises and implements mammography screening programmes in the whole of Greece. In Western Greece, a mammography-screening programme was first introduced in the prefecture Ilia in 1989 as part of the pilot project Europe Against Cancer. In the prefecture Aitoloakarnania, the programme is running since 2001. Screening is done in mobile units, which are stationed at various places in the prefectures (towns and villages) for a certain period of time. A mini-bus service is run together with the mobile screening service for the transportation of women who live in far outlying areas. A period of 4-5 months is required to prepare the programme and inform the public before screening is done in any particular area. The local authorities assisted with the organisation and planning of the programme by offering rooms in which local offices of the HSO could be housed and made it possible for the mobile units to be stationed at particular points by providing electricity, water and telephone lines. In Ilia, the mobile unit was stationed at 25 points within the prefecture. The programme employs two surgeons, two computer specialists, two drivers, four radiographers and a further twelve persons who help with administrative work. Furthermore, 3 surgeons, seven radiologists, two cytologists, a radiation physician and an epidemiologist are employed on a parttime basis. The Greece Against Cancer programme is mainly financed by the Hellenic Foundation of Oncology and run according to the European Guidelines for Quality Assurance in Mammography Screening. Screening strategy The programme invites women aged 40-64 years every two years. Demographic data from the National Statistical Service of Greece and from voters’ registers were entered into an electronic database at the HSO’s main office and used for the invitation of women in the target population. Every woman who attends the screening programme has to complete a question- - 142 -

Benchmarking Regional Health Management II (Ben RHM II) ___________________________________________________________________________________________________________________________________________________________________ naire covering information about the personal medical history and the family’s history of breast cancer. Two-view mammography is done at every visit and the mammograms, together with the questionnaire, are sent to the HSO main centre in Athens on a weekly basis. Only women who attend the initial screening round are invited for the next round. Dissemination of results Mammography is carried out by radiographers and radiologists. The mammograms are independently read by two experienced radiologists in Athens. In case of disagreement in the diagnosis, a third reading is organised in which 5 persons (including the two radiologists concerned) participate. When a mammogram is positive, the woman is invited for further assessment to the point where the mobile unit will be stationed at that time. A medical team comprising a surgeon, a radiologist and a cytologist will clinically examine her. Should surgical biopsy be necessary, the woman is referred to the reference centre (University Hospital Rio, Patras, Western Greece), or to the breast clinic at the oncology hospital in Athens. Women who are not willing to go to the reference centres, to which they have been referred, are given copies of their examination and result documents, so they can go to a hospital of their choice. Information and education Before screening is done in any area, numerous information events are organised, not only by the HSO but also by local authorities and churches. For instance in the prefecture Ilia, the bishops initiated a memorandum to be read at the end of each church service to encourage all women to take part in the screening programme. The points where the mobile unit will be stationed are also published out in the newspapers, television and radios. Professionals involved in the screening programme are informed about new developments and guidelines through special further training courses, seminars, medical journals as well as congresses. Programme related projects/campaigns The HSO and other organisations such as the Red Cross and women’s organisations arrange many information campaigns for the public in the areas where screening programmes are being implemented. - 143 -

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