Since May 2018, we have spent considerable time developing the protocol, and collecting “high-resolution” data (stage, staging procedures, bio-markers, treatment) for breast, cervical and ovarian cancers, in as many countries as possible. This is a major undertaking.
We held three VENUSCANCER Working Group meetings to discuss the protocol during international conferences. In February 2019, we invited over 300 cancer registries to complete online questionnaires to identify which registries have data at the required level of completeness, or are willing to improve their data. We presented a report in Lisbon, Portugal (2019), in Vancouver, Canada (2019) and in Moscow, Russia (2019). By September 2019, 123 cancer registries in 42 countries (4 LMIC, 14 UMIC, 24 HIC) had submitted at least one questionnaire, but 80% submitted all three. We included cancer registries with the highest availability and completeness of the required data.
Despite the difficulties posed by the COVID-19 pandemic and by Brexit, we finalised the legal contracts to permit the transfer of funds for data collection to selected cancer registries in LMIC, and data-sharing agreements with cancer registries in the 27 EU Member States, to enable transmission of sensitive personal data in compliance with the EU GDPR.
We have created the largest population-based high-resolution database for breast, cervical and ovarian cancers.
VENUSCANCER has produced the first real-world picture of the patterns of care and consistency with clinical guidelines for three of the most common cancers in women, using population-based data on a global scale. The first article is now in press with The Lancet.
Consistency of initial treatment with the main international clinical guidelines (ESMO, ASCO, NCCN) was very variable, particularly for surgery in early-stage breast cancer; for chemotherapy in advanced cervical cancer, and for surgery plus chemotherapy in metastatic ovarian cancer. Prompt access to optimal treatment for these three cancers is available for early-stage tumours in most countries, where some type of surgery is offered to most women. This means that if women in LMIC are diagnosed early, they can receive the same guideline-consistent treatment as in HIC. Unfortunately, the proportion of women who are diagnosed at an early stage in LMIC is still far too low. Lack of radiotherapy is still a major issue in LMIC, where mastectomy represents the only available option for women with breast cancer. Chemotherapy was a very frequent option, even in LMIC. The median time to treatment for early-stage cancer was generally less than one month in several HIC, but as long as four months to a year in some LMIC, leading to more advanced stage and sub-optimal treatment. Several cancer-specific articles will follow.
We have finalised the analysis on world-wide trends in avoidable premature deaths. These are the deaths that could be avoided if 5-year net survival in a given country were as high as in a comparator country with higher survival. We have produced results on avoidable premature deaths for breast and ovarian cancer for HIC and for LMIC, also by racial/ethnic minorities in selected countries. These articles will be submitted to high-impact journals shortly.
