Cancer is the leading or second cause of death in most countries in Europe, with breast, cervical and colorectal cancer responsible for 20% of cancer mortality. Substantial progress has been made in the early detection and treatment these cancers and steady declines in cancer mortality have been observed since the 1980s in most Western European countries. However, declines started a decade later in Central and Eastern Europe and for colorectal cancer and cervical cancer even increasing trends can be observed in some Eastern-European countries.

Differences in cancer mortality are caused by differences in treatment and in the effectiveness of screening programmes. Although many Eastern European countries have implemented some form of breast, cervical and colorectal cancer screening, their implementation is currently far from optimal. Key barrier in most of these countries is that they more often have non-organised (opportunistic) screening programmes, leading to lack of data collection and lack of good quality assurance systems. In addition, coverage of opportunistic screening is commonly low and vulnerable minority groups are not reached. We could overcome this with introduction of the programmes adjusted to local context regarding the fit to the culture, health system capacities and technologies available.

EU-TOPIA-EAST (Horizon 2020, 2021-2026) builds upon the EU-TOPIA project (Horizon 2020, 2015-2020). In EU-TOPIA-EAST, we will implement interventions to achieve improvements in cancer screening in three Eastern- European countries (Georgia, Romania and Montenegro) and mobilise key stakeholders in other countries.

Objectives

The overall goal of EU-TOPIA-EAST is to implement effective screening programmes for breast, cervical and colorectal cancer in three exemplary MICs in Eastern Europe (Georgia, Romania and Montenegro) and to build capacity for screening implementation in other Eastern European and Mediterranean countries, in order to reduce the cancer burden in these countries and to achieve equity in cancer care.

More specifically, our objectives are to:

1. Extend, update and refine the innovative road maps, which were initiated in the EU-TOPIA project by Georgia, Montenegro and Romania, into concrete action plans with steps and timeliness to successfully implementing these.
2. Follow the steps in the road maps and action plans and implement in some regions the identified feasible interventions in the existing screening programmes for breast cancer in Georgia, for cervical cancer in Romania colorectal cancer in Montenegro.
3. Monitor the impact of the implemented interventions on important short-term screening performance indicators, such as participation and detection rates.
4. Estimate required resources, health outcomes (benefits and harms, quality of life) and cost-effectiveness of scaling up the interventions to a national level and to other MIC in Eastern-Europe and the Mediterranean using innovative dedicated microsimulation models.
5. Disseminate good implementation practices from participating countries to other MIC in Eastern Europe and the Mediterranean by organising interactive workshops and round table discussions with national, regional and local policymakers and other stakeholders.