Over 15,000 volunteers from all regions of Italy already registered in the national database, half of these (over 7,000) were eligible and 4,560 have already performed the CAT scan, while the others will do so by the summer. It is the first assessment one year after the launch of Risp, the Italian pulmonary screening network (www.programmarisp.it), the first free national program launched a year ago, supported by the Ministry of Health and promoted by the National Cancer Institute of Milan with the participation of 18 centers throughout Italy. The screening provides for the free involvement of 10,000 smokers between 55 and 75 years of age, current heavy smokers or smokers for less than 15 years, with the free offer of low-dose computed tomography and a smoking cessation program using the drug cytisine. Objectives, to save over 5,000 lives every year and standardize screening for the early diagnosis of lung cancer.
In 2022 – reads a note – around 43,900 new diagnoses of lung cancer were estimated, of which 14,600 among women. This is, to date, the second most frequent malignancy in men and the third in women. The aim is to stimulate institutions to include this type of screening for early diagnosis in the essential levels of assistance. Low-dose spiral CT with the support of artificial intelligence – continues the note – is the strategic weapon in the diagnosis of lung cancer, but also for the prevention of diseases of the cardiovascular and respiratory systems.
“The goal – explains Ugo Pastorino, director of the complex structure of thoracic surgery and coordinator of the Risp program – is to demonstrate that it is possible to reduce the mortality of lung cancer in heavy smokers at high risk thanks to screening with computed tomography at low dosage for early diagnosis and with a path of smoking cessation that also includes the administration of the drug cytisine. And if the data we obtain confirm our hypotheses, the next step will be to stimulate the institutions to include this approach in the essential levels of assistance, thus making both low-dose CAT scans and anti-smoking drugs reimbursable with the NHS for those who are at high risk”.
According to the latest data from Passi (Progress of healthcare companies for health in Italy) and Passi d’Argento, in Italy 24% of 18-69 year olds smoke and of these, 22% consume more than one pack of cigarettes a day. “Our Institute has always been at the forefront in the fight against smoking, and for years we have been committed to promoting programs aimed at encouraging and supporting smokers in their path to smoking cessation – explains Marco Votta, president of the Int – We have also set up a campaign permanent anti-smoke to make the hospital smoke-free, also with the help of very significant images present throughout the structure, from the entrance to the atrium and in the corridors”.
As part of the Ris programme, Int Milano has promoted the distribution of cytisine to the Centers participating in the project – details the note – This drug, until now only available in a galenic formulation, is now available in ad hoc prepared tablets, currently only for administration to study participants. Cytisine is an anti-smoking drug with many advantages, as demonstrated by a study conducted by Int together with the Mario Negri Institute in Milan and the University of Parma. “It is a well-tolerated active ingredient, with almost no side effects and which, unlike nicotine, does not create addiction – claims Roberto Boffi, head of Pneumology and the INT’s anti-smoking center – It has a dosage schedule that provides for a 40-day therapy, with the stop smoking scheduled between the eighth and the 14th day, divided into several daily intakes due to the short half-life of the active ingredient. This limit, however, can also be its trump card because it replaces the ritual of the cigarette”.
The Risp Program provides for the execution of the thoracic spiral CAT at low exposure doses, in line with the results of the latest studies conducted in the USA, Europe and Italy. All have demonstrated its effectiveness in the early diagnosis of lung cancer. “We analyze the results of the CAT scan with the support of artificial intelligence which allows us to reduce false positives and, consequently, surgical interventions for benign pathologies – highlights Nicola Sverzellati, director of the Radiological Sciences Unit Aou of Parma and full professor in the Department of Medicine and surgery of the University of Parma – We also use latest generation equipment which is extremely quick to perform and, even more importantly, exposure to a minimum dose of radiation, without compromising the quality of the images”.