The slogan for the Estonian Cancer Society’s first undertaking “Cancer Can Be Prevented and Cured” is still relevant today. Since 2004, the Estonian Cancer Society has persistently organised cancer prevention campaigns which are of prime importance in our battle against cancer. Our partners are the Ministry of Social Affairs, the Estonian Health Insurance Fund and the National Institute for Health Development.
Each year, in January and May, on the initiative of the Estonian Cancer Society, cervical and breast cancer publicity campaigns are organised with the following slogans: “Kingi endale kindlustunne” (“Give Yourself a Sense of Security”) and “Ära jää hiljaks” (“Don’t Be Late”).
In Estonia, approximately 700 women develop breast cancer and 190 women are diagnosed with cervical cancer every year.
The cancer screening programme is still aimed at insured women, the target group for cervical cancer screening programme consists of 30–55-year-old women; and the target group for breast cancer screening programme consists of 50–62-year-old women.
The screening clinics are funded by the Estonian Health Insurance Fund and these diagnostics are cost free for women in the target group who have national health insurance.
Our primary goal is to improve the awareness of women, but also the awareness of the public and medical workers about the prevention of cervical and breast cancer and the importance of early detection.
Screening for colorectal cancer
In the second half of thisyear, the Health Insurance Fund will initiate the financing of the screening for colorectal cancer, which is aimed at people aged 60–69-years old, insured under the statutory health insurance scheme. Early detected precancerous condition allows preventing or treating the disease with significantly better results.
The formation process of colorectal cancer is slow and gradual, and the early detection of its benign tumors in the initial stage helps prevent the formation of the colorectal cancer. To reduce the morbidity and mortality, population-based screenings done by occult blood tests and colonoscopy are in use in many countries.
In Estonia, 800-900 people fall victim to a colorectal cancer every year. The target group for colorectal cancer screening in Estonia is people aged 60–69-years old; men and women, who are born in 1956 and who are insured under the statutory health insurance scheme will get an invitation in the second half of next year.
“The incidence of malignancies is a growing trend in the society. Therefore, the Health Insurance Fund considers the contribution to the early detection of cancer, in terms of both the human health and conservation of health insurance resources, and the importance of raising awareness of participation in screening programs to be very important,” said Mari Mathiesen, member of the Management Board at the Health Insurance Fund. “When launching the evidence-based screening programs, creation of opportunities is not enough, it is important to consistently pursue that the participation of the target group of the trial would be sufficient, and we intend to do serious work to include people,” emphasized Mathiesen.
“We commit each day to make the decisions and choices. The same applies to our health behavior, where receiving an invitation to the screening, each person decides whether to participate in the screening or not,” explained Diana Ingerainen, Head of the Estonian Society of Family Doctors, “Family doctors encourage to certainly participate in trials, and we do everything we can to advise patients. In my daily work as a doctor, I can see clearly the importance of prevention. Screening is one way to detect a possible illness earlier and treat it more successfully,” explained Dr. Ingerainen.
The Health Insurance Fund has financed two evidence-based screening programs directed at women for more than ten years, and next year, we will start the financing of the screening for colorectal cancer, which is the first two-part screening in Estonia, where the family doctor system has a leading role. “Our primary care medicine is well advanced and the family physicians and the family nurses working with them are good, which is why the screening for colorectal cancer is planned to be launched among the family doctors,” added Mathiesen.
The person who belongs to the target group will receive the invitation for colorectal cancer screening at the postal address indicated in the population register. The invitation also has an explanation about the participation in the screening. For participation in the trial, it is necessary to visit a family doctor. The family doctor or nurse will provide the person with an occult blood test, instructions for use and an envelope for sending the test. The person will make the test at home and send it to the lab. The postage costs for sending the analysis involve no additional expenditures for people.
If the test results are fine, a notice about this will be sent to the person, who will then receive an invitation to participate in thescreening for colorectal cancer after two years. However, if the lab finds occult blood in the analysis, a further study will be required. A notice about findings and all the information on further steps will be sent to the person. At each stage, the person may contact his or her general medical practice for questions and advice.
Care about your health, and when receiving the invitation for screening, participate in the trial, it is in the interest of your health. Early detected cancer and precancerous conditions can be treated.