Full list of projects 2000

Title of Project QUALITY ASSURANCE AND QUALITY CONTROL IN THE PROGRAMME FOR THE PREVENTION OF GYAECOLOGICAL CANCERS AND INFECTIONS
Organization Name: JUNTA DE CASTILLA Y LEON. CONSEJERIA DE SANIDAD Y BIENESTAR SOCIAL Address: Avda. de Burgos,5 E-47071 - VALLADOLID Telephone / Fax: +34 983 41 36 62 / +34 983 41 37 42 Web site: E-mail: antonio.saez@csbs.jcyl.es Contact person: Mr CARLOS FERNANDEZ CARRIEDO	Partner Countries B,D,DK,E,EL,F,I,IRL,P,S,UK
Start of Project 1/07/2000	Duration of Project (months) 18
Project Objectives and Action Plans Cervical cancer is one of the malign tumors in which we find clear evidence that detection and early treatment have the potential of reducing the mortality or undoubtedly increasing the survival of women who present this disease. Since 1994 the '' Programme for the Prevention of Gynaecological Infections and Cancers of Castilla y Leon'' forms part of the European network of pilot programmes for the Screening of Cervical Cancer, and functions according to the European directives with a view to improving the quality of Cervical Cancer Screening.The new project '' Quality Assurance and Quality Control'' is based in the following objectives and activities. - Guarantee the quality in each one of the activities in the programme - Promoting the research in the field of detection of HP viruses in screening - Extend the introduction of the Cancer Prevention Programme to 100% in the Basic Healthcare Zones - Increase the participation of the target population so that 85% of them have access to the Programme every 3 years. - Carry out the monitoring and follow up of detected pathologies in 100% of cases.

Title of Project EDRO - EDUCATION FOR RADIATION ONCOLOGY
Organization Name: EUROPEAN SOCIETY FOR THERAPEUTIC RADIOLOGY AND ONCOLOGY Address: Avenue .E. Mounierlaan 83/4 B-1200 - BRUSSELS Telephone / Fax: ( + 32-2 ) 775 9340 / ( + 32-2 ) 779 5494 Web site: E-mail: michael.baumann@mailbox.tu-dresden.de Contact person: Prof MICHAEL BAUMANN michael.baumann@mailbox.tu-dresden.de	Partner Countries A,B,D,DK,E,EL,F,FIN,I,IRL,L,NL,P,S,UK
Start of Project 1/06/2000	Duration of Project (months) 17
Project Objectives and Action Plans Improving the standards of cancer treatment by raising the quality of education for radiotherapy. There is a direct relationship between the therapeutic outcome for the treatment of cancer with radiotherapy and the precision in the prescription and the delivery of the radiation. Precision can only be achieved if the level of education of practitioners parallels the sophistication of the new tools the industry is providing them with and if the latest research findings are translated to the clinic. To achieve this goal 10 modular teaching courses will be organized in different areas of Europe covering the minimum curriculum for the theoretical education for radiation oncology at a basic and advanced level. The courses are meant to set European standards of excellence, to train the future teachers and to support, stimulate and complement the teaching efforts of the National Radiation Oncology Societies. To prevent our future European partners from falling behind, the Central European countries as well as Turkey are included in the ESTRO teaching programme. Between January 2000 and October 2001, minimum 19 courses will be organized. Depending on when the contract year can start ( tentatively.1 March 2000 ) 10 courses organized in different EU countries will be selected for the project. The EU fellowships provide a powerful incentive for young people to invest in their professionnal education. Many of the winners of an EU fellowship have already come back for other ESTRO courses at their own expense.

Title of Project 2 ND ELPIDA AWARD
Organization Name: ELPIDA-FRIENDS ASSOCIATION OF CHILDREN WITH CANCER Address: 46, Mikras Asias Str. EL-11527 - ATHENS Telephone / Fax: ( + 30-1 ) 775 7153 / ( + 30-1 ) 775 2989 Web site: E-mail: elpida@hellasnet.gr Contact person: MARIANNE VARDINOYANNIS	Partner Countries A,B,D,DK,E,EL,F,FIN,I,IRL,L,NL,P,S,UK
Start of Project 1/02/2000	Duration of Project (months) 12
Project Objectives and Action Plans Focusing interest in paediatric oncology. Sensitising public opinion in Europe. Promotion of initiatives and support for scientific studies and dissemination of their conclusions and/or of social work done in this field, particulary actions tending to improve the quality of life of sick children and their families by a novel approach and/or having value as models, for instance in the field of: - schooling for the sick child or - the quality of life in hospital or - informing the family or - the scholastic and social integration of the child that has been cured or is in remission, etc... Actions eventually valuable as models of European cooperation, or contributoing towards the advancement in this field, will be particularly taken into consideration. Exchanging experience with other bodies throughout Europe. Promoting the target of "Europe with a human face " a children's Europe.

Title of Project AMÉLIORATION DES HABITUDES ALIMENTAIRES PAR LE WEB EXTENSION DU PROJET
Organization Name: EUROPEAN CANCER PREVENTION ORGANISATION Address: Rue Martin V, 40 B-1200 - BRUXELLES Telephone / Fax: ( + 32-2 ) 779 06 68 / ( + 32-2 ) 779 06 68 Web site: E-mail: ecp0001@worldonline.be Contact person: Dr ALAIN MASKENS	Partner Countries B,I,UK
Start of Project 1/09/2000	Duration of Project (months) 15
Project Objectives and Action Plans Le succés d'une stratégie de prévention du cancer nécessite une modification des facteurs de comportement impliqués dans son étiologie. Une politique active d'éducation nutritionnelle est essentielle aujourd'hui pour améliorer la qualité de vie et promouvoir le bien-être mental, social et physique de l'individu . L'application d'une telle politique doit donc comprendre la diffusion des connaissances mais aussi la création d'outils qui aideront le citoyen à utiliser effectivemeny ses connaissances dans sa vie future.Or, on constate une certaine méconnaissance des principes de base de l'équilibre alimentaire et de son rôle préventif dans l'apparition de certaine maladies tel que le cancer. Au milieu des nombreux débats et des polémiques qui agitent périodiquement le monde de la nutrition, des messages de base tels que la promotion de la variété et le respect des rythmes alimentaires conservent toute leur force et s'inscrivent dans un discours unanimement reconnu par les spécialistes. Les objectifs du projet consistent donc à: 1. Poursuivre, grâce aux techniques Internet, la mise à disposition à l'ensemble des citoyens européens des principes d'une alimentation équilibrée. 2. Diffuser en outre les recommandations nutritionnelles en matière de prévention du cancer ( l'apport en fruits, légumes, céréales ; la consommation en matière grasse ) . 3. Illustrer par quelques conseils simples et des exemples de recettes comment mettre en pratique ces recommandations. 4. Susciter, chez les consommateurs, grâce à l'organisation du site Internet, la volonté d'approfondir leurs connaissances en matiére de nutrition et de santé, le but ultime étant de laes amener progressivement à adopter un comportement alimentaire sain. 5. Développer le caractère interactif du site en proposant des questionnaires évolutifs qui permettront l'individualisation de l'information donnée. 6. Mettre l'accent sur la gestion pédagogique de notre méthodologie. 7. Inviter les associations professionnelles et NGO à partager ce site en fournissant des listes de matériel d'information disponible. 8. Poursuite du développement du site en trois langues supplémentaires: néerlandais, allemend, espagnol ( les langues actuelles du site sont: français, anglais, italien ). 9. Participer activement aux événements organisés par les Etats Membres dans le cadre de la problématique " nutrition et prévention du cancer\" et plus particulilèrement lors de la semaine européenne de la nutrition ( 10/2000); nous feront le lien avec les activités choisies par la présidence française. 10. Etablir et présenter les liens vers d'autres rpogrammes communautaires ( dg V, VI, XII, XIII ), plus particulièrement les résultats d'EPIC et d'autres études cofinancées par le programme. The success of a cancer prevention strategy calls for a change in the behavioural factors involved in its aetiology. An active alimentary education policy is essential today if the quality of life and the mental, social and physical wellbeing of the individual is to be improved. The pursuit of such a policy must, therefore, include the dissemination of knowledge as well as the creation of tools that can help people to use effectively their knowledge in their lives in future. However, there are signs of an degree of ignorance with regard to the basic principles of a balanced diet and its role in preventing the onset of certain diseases such as cancer. At the centre of the many discussions and arguments which regularly ripple through the world of nutrition, fundamental messages such as the promotion of a varied and regular diet continue to be valid and form an integral part of what is universally recognised by the specialists. The objectivse pursued by the project are the following. 1) To continue, using Internet technology, to provide all European citizens with information on the principles of a balanced diet. 2) To disseminate the nutritional recommendations in terms of cancer prevention ( eating more fruit, vegetables, cereals; the intake of fatty foods.). 3) To illustrate, using a number of simple pieces of advice and model recipes, how these recommendations can be put into practice. 4) To use the Internet site to generate in consumers a desire to deepen their knowledge of health and nutrition, the overall aim being to induce them progressively to adopt a healthy diet. 5) To develop the interactive nature of the site by proposing adaptable questionnaires that will allow the information provided to be targeted. 6) To emphasise the importance of the educational management of our methods. 7) To invite professional associations and NGOs to become involved in the site by providing lists of the information they can make available. 8) To continue with the development of the site in three additional languages: Dutch, German and Spanish ( the current languages being French, English and Italian). 9 ) To become actively involved in the events organised by the Member States as part of the good nutrition and cancer prevention effort, more particularly on the occasion of the European Nutrition Week (10/2000) ; we will establish the link to the activities selected by the FRench Presidency. 10) To establish and present the links to other Community programmes (DGV,VI,XII,XIII), more specifically the results of the EPIC survey and other studies cofunded by the programme.

Title of Project CD-ROM KREBSPRÄVENTION UND ERNÄHRUNG
Organization Name: DEUTSCHE KREBSGESELLSCHAFT E.V Address: Paul Ehrlich Str. 41 D-60596 - FRANKFURT/MAIN Telephone / Fax: ( + 49 ) 696300960 / ( + 49 ) 69639130 Web site: E-mail: prevention@deutsche.krebsgesellschaft.de Contact person: RAINER BREDENKAMP	Partner Countries A,D,E,EL,FIN,S, NO
Start of Project 1/01/2000	Duration of Project (months) 12
Project Objectives and Action Plans Die CD-ROM " Krebsprävention und Ernährung " ist ein Anschlussprojekt an die Produktion der CD-ROM " Ratgeber Krebs" . Dieses Medium wurde 1999 fertig gestellt und mit sehr gutem Erfolg vertrieben. Eine 1. Auflage von 10 000 Exemplaren wurde bislang abgesetzt. Die digitalisierten Informationen sind vielseitig einsetzbar. Die CD-ROM bietet die Möglichkeit, spezifische Elemente der Produktion im TV und im Internet zu nutzen. Ziele des Projekts: - Vermittlung von fundierten, seriösen und aktuellen Informationen zum Thema " Krebsprävention und Ernährung ". - durch eine interaktive Multimedia CD-ROM über TV und im Internet . - die Zielgruppen sind interessierte Laien. - die CD-ROM soll im Aus- und Fortbildungsbereich eingestzt werden. - durch die Information soll das Gesundheitsverhalten der Benutzer positiv beeinflusst werden. - es geht darum , die Benutzer der CD-ROM über die Möglichkeiten und den Nutzen der Primärprävention von Krebs durch eine gesunde Ernährung aufzuklären und zu einem krebsprävention Verhalten zu motivieren. This CD-ROM on diet and cancer prevention is a follow-up to the CD-ROM Ratgeber Krebs ( cancer advice ), produced in 1999 and marketed with considerable success. So far, a first edition of 10 000 copies has been distributed. The digitised information has multiple uses. The CD-ROM enables specific elements of the production to be used with TV or Internet. Project aims: - To provide well-founded, reliable and up-to-date information on the subject of diet and cancer prevention by means of an interactive multimedia CD-ROM via TV and Internet. - The production is aimed at the interested general public. - The CD-ROM is intented for use in education and training. - the information is intended to have a positive influence on the health behaviour of users. - The general purpose of the CD-ROM is to inform users about the possibilities and value of primary prevention of cancer trough healthy diet and to encourage behaviour which will reduce the risk of cancer.

Title of Project EUROPEAN PROSPECTIVE INVESTIGATION INTO CANCER AND NUTRITION ( EPIC )
Organization Name: INTERNATIONAL AGENCY FOR RESEARCH ON CANCER Address: 150, cours Albert-Thomas F-69372 - LYON CEDEX 08 Telephone / Fax: ( + 33-472 ) 73 8485 / ( + 33-472 ) 73 8575 Web site: E-mail: Riboli@iarc.fr Contact person: Dr PAUL KLEIHUES	Partner Countries D,DK,E,EL,F,I,NL,S,UK
Start of Project 1/06/2000	Duration of Project (months) 12
Project Objectives and Action Plans Research on diet and cancer has so far indicated that a diet rich in vegetables and fruit is associated with reduced risk of cancers of the digestive and respiratory tracts and possibly of other cancers. While current knowledge is sufficient to make broad dietary recommendations, many imporatnt questions remain to be answered. The main aim of the European Prospective Investigation into Cancer and Nutrition ( EPIC ) is to investigate the role of dietary habits, lifetsyle, and nutritional and anthropometric characteristics in determining the risk of cancer and chronic diseases. While current knowledge is sufficient to make broad dietary recommendations, many important questions remain unanswered, and can be investigated by the EPIC study, and particularly: - which compounds in vegetables and fruiots protect against cancer and CVD - the role of meat and fat in cancer etiology - the possible protective effect of fish consumption - the role of dairy products - the effect of physical activity and physical fitness in the prevention of cancer and CVD - the relation between several biomarkers of nutritional and metabolic status and subsequent cancer risk.

Title of Project REVIEW OF EUROPEAN CORE CURRICULUM FOR RADIOTHERAPY TECHNOLOGISTS
Organization Name: EUROPEAN RADIOTHERAPY TECHNOLOGISTS EDUCATION DEVELOPMENT GROUP ERTED/ESTRO Address: Avenue Mounierlaan 83/4 B-1200 - BRUSSELS Telephone / Fax: ( + 32-2 ) 775 9340 / ( + 32-2 ) 779 5494 Web site: E-mail: mieke.akkers@estro.be Contact person: PIERRE SCALLIET	Partner Countries A,IRL,S,UK
Start of Project 15/12/2000	Duration of Project (months) 17
Project Objectives and Action Plans The project will be based on the findings of literature reviews which will look at cancer patient needs, current and future developments in Radiotherapy and 97/43/EURATOM on reduction of the radiation dose due to medical exposure to the general public. The findings of these literature reviews will be collated and presented to a workshop for integration into a revised core curriculum for radiotherapy technologists. This scientific base will ensure that clinical practice is knowledge based and integrates all aspects of the treatment process. The ultimate beneficiary will be the cancer patient who will receive the optimum course of treatment delivered by a knowledge and skilled practitioner. Radiotherapy is a team process and to date the education of the radiotherapy technologist has failed to meet the level of development of the other professionals involved in the treatment process. It is important that all personnel involved in the delivery of radiotherapy understand the principles upon which practice is based and reach an equal level of knowledge and technical ability in their specific area. The revision of the core curriculum will ensure knowledge is current and will encourage continuing review and update of education programmes for radiotherapy technologists. The adoption of this core curriculum across Europe will ensure a uniform educational standard is achieved prior to entry into clinical practice and will both facilitate and encourage free movement of personnel across the member states. The countries of the eastern European block will be invited to participate in this project and will help with educational developments in these countries to ease entry into the community.

Title of Project CANCER GENETICS AND GENETICS COUNSELLING COURSES FOR PEDIATRIC ONCOLOGISTS AND NURSES
Organization Name: EUROPEAN GENETICS FOUNDATION Address: Palazzo del Melograno - 2/8 piazza Campetto I-16123 - GENOVA Telephone / Fax: ( + 39-0 ) 10 246 46 46 / ( + 39-0 ) 10 246 60 55 Web site: www.eurogene.org E-mail: eurgef@tin.it Contact person: CARLO BERIO	Partner Countries F,I,NL,UK
Start of Project 1/01/2000	Duration of Project (months) 12
Project Objectives and Action Plans The present application aims at organizing in the Autumn 2000 two courses focusing on pediatric oncolgy. The two courses are directed to two different professional categories, physicians and biologists in the first case, nurses and psychologists in the second although attendance of both courses by both types of professionals will be encouraged. This type of courses have been organized repeatedly for the past 12 years by the European Genetics Foundation (EGF) in ( Sestri Levante ( Italy ) which has become the center of reference in Europe for advanced training in Genetics ( see website www.eurogene.org.). In addition to the two Institutions which have been collaborating with EGF for the previous courses, Gaslini Institute ( Genoa ) , the largest pediatric hospital in Italy, and IARC ( International Agency for Research on Cancer- Lyon, France ), other Institutions active in the field of pediatric oncology and the networks of pediatricians and nurses already existing in Europe will be involved. The counselling aspects peculiar of pediatric oncology will represent the innovative feature of the new Genetic Counselling course which will attract a lot of attention from European pediatric oncology centers. A particular effort will be made to recruit all the experts in this field in Europe as Faculty members. According to the evaluation given by all the participants who have attended so far the Cancer Genetics course ( 1996,1997,1998 ) and the first course in Genetic Counselling ( 1999 ) , this type of activity should be maintained and further supported in Europe. The two new courses of the year 2000 should draw a lot of attention because of the interest of the subject of pediatric oncology and will be very instrumental in creating and reinforcing European networks of professionals working on research and care of patients affected with neuroblastoma, retinblastoma, Wilms tumour,etc. For the past four years a course in Cancer Genetics has been jointly organized by the EGF, the Gaslini Institute (Genoa), the largest pediatric hospital in Italy, and IARC ( International Agency for Research on Cancer-Lyon, France ) . The course is the first of its kind in Europe and has been attended so far by almost 200 students. More than 70 students have registered already for the 4th course scheduled between September 29-October 3, 1999. Following this course a new one directed particularly to genetic nurses entitled Genetic Counselling in Practice will be held in Sestri Levante ( October 3-9,1999). More than 40 nurses have already registered by the end of August 1999. Both courses have been approved in principle for support by the Europe against Cancer programme 1999. The success of these two courses in terms of participants that there is a need in Europe for this type of training. The present application aims at continuing this experience by organizing in the Autumn 2000 two similar courses focused in particular in pediatric oncology. In addition to the two Institutions which have been collaborating with EGF for the previous courses (Gaslini and IARC) a particular effort will be made to involve other Institutions active in the field of pediatric oncology and the networks of pediatricians and nurses already existing in Europe in order to fulfill the objective described under action 17 of the decision N.646/96/EU of the European Parliament and Council of 26/3/1996, following the recommandation of the Commission dated 08/11/1989. This collaboration with other European Institutions and networks will occur only at the scientific level. No subcontracts will be needed and all the organizational work will be carried out by EGF. Contributions in kind ( scientific, tehcnical and admistrative personnel's time will be provided by the collaborating Institutions ( Gaslini and IARC in particular). The counselling aspects peculiar of pediatric oncology will represent a novel and interesting feature of the Genetic Counselling course which should attract a lot of attention from European pediatric oncology centers. A particular effort will be made to recruit all the experts in this field in Europe as Faculty members. The two courses are directed to two different professional categories, physicians and biologists in the first case, nurses and psychologists in the second although attendance of both courses by both types of professionals will be encouraged. The main feature of the Sestri Levante courses is represented by the high scientific standard of lectures and workshops, by the continous presence of the Faculty during the course and by their continous interaction with students through workshops and informal discussions. As a result these courses have been very useful in the past to establish a link among different groups working in Europe in the same area of research and also to facilitate the transfer of information and knowledge from basic research into clinical practice. The venue of the course, situated in a small attractive city of the Italian Riviera, the relatively low cost in registration and tuition fees averaging 300 Euro for a 5-6 day course ( this fee includes also lunch and coffee breaks every day at the venue of the course ), the low cost of hotels in Sestri Levante in addition to the availability of fellowships usually for 25% of the participants represent the ideal organizational set up which guarantees the success of each course. Fellowships usually cover registration fees and living expenses, no travels. The tradition established by the courses of the ESMG in the field of cancer research deserves to be continued, according to the evaluation given by all the participants who have attended so far the Cancer Genetics course (1996,97,98). The number of participants in the 1999 course should be in the order of 80, while the number of nurses and psychologists attending the first course in Genetic Counselling should be in the order of 40. The two equivalent courses of the year 2000 should draw a lot of attention because of the interest of the subject and will be very instrumental in creating and/or reinforcing European networks of professionals working in the field of pediatric oncology ( neuroblastoma, retinoblastoma, Wilms tumour...).

Title of Project PREVENTION OF DEVIATIONS AND ACCIDENTS THROUGH QUALITY ASSURANCE PROGRAMME FOR RADIOTHERAPY CENTRES IN EUROPE
Organization Name: NETWORK OF EUROPEAN CENTRES Address: 49, Herestraat B-3000 - LEUVEN Telephone / Fax: +32/16/34.69 13 / +32/16/34.76.10 Web site: E-mail: Contact person: Dr BART VAN DAELE	Partner Countries A,B,D,DK,E,EL,F,I,IRL,NL,P,S,UK
Start of Project 1/09/2000	Duration of Project (months) 12
Project Objectives and Action Plans The aim of the project is to further continue the development of the European Network of Radiotherapy Centres, which develops the procedures for quality control ranging from equipment calibrations to the core procedures of the process of radiotherapy from treatment preparation to treatment delivery. The Network started in 1991 and now firmly established in 13 member states throughout Europe, is assessing feasibility studies in the quality control of radiotherapy treatment not only in centres with research expertise (national reference centres of the Network and the centres of the EORTC Radiotherapy Group) but also including local centres without specialised know-how. The final goal of the project is to transfer these methodologies to the ESTRO (European Society for therapeutic Radiology and Oncology) so that procedures can be harmonised at a European level. Based on the results obtained in the previous years through the Network and in collaboration with the European organisations (EORTC, ESTRO), it is proposed to continue to develop and to implement quality assurance procedures for radiotherapy through the following complementary objectives which are the goals to be achieved in the continuation of this project: - In the frame of transfer of know-how to the radiotherapy community and in analogy to the photon beams and the electron beams in reference conditions it is presently time to transfer the methodology developed in this Network about the OPERA phantom (Operational Phantom for European Radiotherapy Audits) to the EQUAL structure in order to start quality control of photon beams in non-reference conditions at a full European scale. The project to monitor treatment preparation by measuring standards in the treatment preparation process (EQUART, European Quality Assurance in Radiotherapy by monitoring Treatment preparation), which was initiated in the EC-Network project 1999 for conventional treatment and which turned out to be very powerful in eliminating major errors in the treatment preparation will be extended to intensity modulated radiotherapy treatment. It is believed that this new approach of quality control of treatment preparations is mandatory with the advent of these new highly sophisticated treatment possibilities, made available to any local centre in Europe. - In the frame of development of new methodologies for quality assurance in radiotherapy, the in vivo dosimetry study performed through the reference centres of the Network, will now be launched at a large scale through the EORTC Radiotherapy Group and more specifically through the EORTC 22922 before its final endorsement by ESTRO-EQUAL. - A feasibility study of in vivo dosimetry for electron beams using semiconductor diodes will be initiated through the reference centres of the Network (calibration procedures, correction factors, etc.)

Title of Project MULTICENTRIC CASE-CONTROL STUDY ON THE AETIOLOGY OF LYMPHOMAS EPILYMPH
Organization Name: CATALAN INSTITUTE OF ONCOLOGY Address: Av. Gran Via s/n, Km. 2.7 E-08907 - L'HOSPITALET DEL LLOBREGAT Telephone / Fax: +34/93/2607812 / +34/93/2607787 Web site: E-mail: s.sanjose@ico.scs.es Contact person: Dc JOSEPH M. BORRAS	Partner Countries D,E,F,FIN,I,IRL,NL, US
Start of Project 15/12/2000	Duration of Project (months) 24
Project Objectives and Action Plans The incidence of all types of lymphomas has been rising in the last 30 years in Europe at an annual rate of approximately 4 %. Recent data support that this rise is confined to some subgroups of lymphomas such as follicle centre cell type, extranodal B-cell, nodal T cell and nodal lymphomas. The reasons for this increase are unknown and do not appear to be explained solely by better diagnosis. It has been recently postulated that the increase in incidence may be due to altered immune reactions to identifiable viral exposures. The project is a multicentric case control study in 6 European countries aiming to identify specific risk factors in the occurrence of lymphoid neoplasms. These studies are funded by national sources.This application concerns the co-ordinated analysis of biological samples collected from cases and controls for the detection of viral infections. Specifically: to identify the contribution of Epstein-Barr virus (BBV), HIV, Hepatitis C virus (HCV)and Herpes virus 8 (HHV-8) to the occurrence of lymphoid neoplasms with up-dated technology.The contribution of environmental exposures has been expanded in a previous application to EAC, 98/CAN/32218) accepted by the Comission The field work is being covered by national Budget.The study will be conducted in France, Spain, Italy, Germany, Finland and Ireland and aims to enrol 2000 cases and 2000 controls. Risk estimates will be obtained for the different infectious agents and potential interaction effects between environmental and occupational exposures with the different viral agents will be estimated. A core protocol has been designed to be adaptable to other potential participant countries.

Title of Project ENYPAT CORE (EUROPEAN NETWORK ON YOUNG PEOPLE AND TOBACCO
Organization Name: NATIONAL PUBLIC INSTITUTE Address: Mannerheimintie 166 FIN-00300 - HELSINKI Telephone / Fax: ( + 358-9 ) 47441 / ( + 358-9 ) 47448 338 Web site: E-mail: erkki.vartiainen@ktl.fi Contact person: Dt ERKKI VARTIAINEN	Partner Countries A,B,D,DK,E,EL,F,FIN,I,IRL,L,NL,P,S,UK
Start of Project 1/07/2000	Duration of Project (months) 15
Project Objectives and Action Plans The aim of the Network is to contribute to the reduction of tobacco use among young people in Europe by: - developing, coordinating and administring the ENYPAT Framework project in order to get wider and more coherent smoking prevention programs at European level: Smokefree Class Competition, Smoke Free Partnerships, Quit and win - Don't start and win, ENYPAT Spring School (appendices). - promoting collaboration between health educators, experts and researchers. - gathering and exchanging information and experiences about smoking, smoking prevention, smoking cessation programs and tobacco policy. - developing relevant systems for smoking prevention programmes in the future.

Title of Project GLOBALINK- TELECOMMUNICATIONS FOR EUROPEAN SMOKING PREVENTION
Organization Name: INTERNATIONAL UNION AGAINST CANCER Address: 3, rue du Conseil Général CH-1205 - GENEVA Telephone / Fax: ( + 41-22 ) 809 18 11 / ( + 1-22 ) 809 18 10 Web site: E-mail: globalink@uicc.org Contact person: Mr TURNBULL ARCHIE	Partner Countries A,B,D,DK,E,EL,F,FIN,I,IRL,L,NL,S,UK, CH
Start of Project 15/06/2000	Duration of Project (months) 12
Project Objectives and Action Plans To develop and operate GLOBALink, The International Tobacco-Control Network. A communication service with 14 Members, half of them being located in Europe: - Linking intergovernmental , national and non-governmental organisations as well as individuals via a secure information system and electronic-conferences, increasing efficiency through improved communication, multimedia and coordination, - Supporting the communication infrastructure of most the European smoking prevention organisations. - Providing instant access to an interactive computer information service with an expanding multimedia data base of reference and resource materials, regular news bulletins and "action alerts".
Outcomes of the project Final report (100 KB)

Title of Project SMOKING, WOMEN AND LOW INCOME
Organization Name: EASTERN HEALTH BOARD Address: Dr. Steevens Hospital IRL-8 - DUBLIN Telephone / Fax: ( +353-1 ) 6790700 / ( +353-1 ) 6700700 Web site: E-mail: Pat.mcloughlin@ehb.ie Contact person: Mr PAT MCLOUGHLIN	Partner Countries B,E,EL,IRL,UK
Start of Project 1/06/2000	Duration of Project (months) 12
Project Objectives and Action Plans Over the past twenty years, there has been a marked decline in the prevalence of smoking amongst men, the percentage of women who are stopping is significantly lower than that of men. In addition to the gender difference in stopping ratios, there is an additional socio-economic difference. Over the past two decades, the prevalence of smoking has declined among higher income groups while among the lowest income quarter it has remained static. This has left an increasing proportion of smokers among low income families. At the same time, an increase in income inequalities, particularly among families, combined with a rapid growth in lone parenthood, has led to a closer association between smoking and family poverty in general, and between smoking and women's poverty in particular. The first year of the Smoking, Women and Low Income project examined smoking in relation to smokers who are women in low income areas. We consulted the women and drew up appropriate initiatives including peer led programmes, to bring tobacco into the health agenda of women, raise awareness and develop practical strategies for supporting women who are trying to change their smoking behaviour. The aims of the second year are: - To demonstrate the universal application of the initiatives developed under the pilot project, Smoking, Women and Low Income. The programme will be tested with women in five countries and will involve all major target groups. - To train sufficient women as trainers to allow the initiatives to continue after the project ends. - To evaluate, report and disseminate the findings to hundreds of organisations and cities throughout Europe. - To test the effectiveness of the initiatives in the area of smoking reduction in the short and long term. - To collate the resources and programme initiatives and distribute to organisations and cities throughout Europe.
Outcomes of the project Executive summary of the final report(220KB) Final report(600KB)

Title of Project PHARMACISTS AGAINST SMOKING
Organization Name: EUROPHARM FORUM SMOKING CESSATION TASK FORCE Address: 8 Scherfigsvej DK-2100 - COPENHAGEN Telephone / Fax: ( + 358 ) 19 341 314 / ( + 358 ) 19 341 147 Web site: E-mail: eeva.terasalmi@salnet.fi OR igu@who.dk Contact person: IDA GUSTAFSEN	Partner Countries A,B,D,DK,E,F,FIN,I,IRL,L,NL,P,S,UK
Start of Project 15/06/2000	Duration of Project (months) 12
Project Objectives and Action Plans The aim of the project is to collect information about the smoking status of the community pharmacists and about their opinions of smoking cessation activities in community pharmacies. This knowledge is needed in order to find more effective methods to reduce smoking among European people and to further develop the work done in the EuroPharm Forum smoking cessation task force. The project is is part of a cooperative project whichhas been started with the European Forum of Medical Associations and the European Forum of Nursing and Midwifery Associations and aims at reducing the prevalence of smoking among health service users and health professionals. The survey is conducted independently from the pharmaceutical industry. The questionnaire is based on models developed by WHO and described in the publication Smoke-free Europe 3, Evaluation and Monitoring of Public Action on Tobacco, September 1987. Furthermore, to assure coherence in questionnaires among health professionals, we have consulted questionnaires in use for similar surveys, e.g. the Tobacco Control Resource Centre questionnaire to medical associations sent out through the Medical Forum.
Outcomes of the project Executive summary of the final report(380KB) Final report, (290KB)

Title of Project EUROPEAN NETWORK OF QUITLINES
Organization Name: QUIT Address: 170 Tottenham Court Road UK-W1P 0HA - LONDON Telephone / Fax: ( + 44 ) 171 388 5775 / ( + 44 ) 171 388 5995 Web site: E-mail: PeterJ McCabe@compuserve.com Contact person: Mr PETER MC CABE	Partner Countries D,E,IRL,NL,S,UK, PL, RO, NO, IS
Start of Project 1/06/2000	Duration of Project (months) 12
Project Objectives and Action Plans There are a number of States which include telephone smoking cessation counselling as part of the support offered to smokers. Amongst the advantages of such a service are its reach, accessibility, relatively low cost and ability to support large numbers of smokers through a serious quit attempt. In the USA the AHCPR Guidelines recommend that " where feasible, smokers should be provided with access to support through telephone helpline as a self help intervention" . Studies from around the world indicate that this is a worthwhile intervention ( see Bibliography ) . The participants in this project believe that sharing expertise and experience will raise the standards of such services so that they are better equipped to help more smokers in Europe in their cessarion efforts. In addition efforts will be made to encourage the development of similar services in those member states where no service currently exists.All of this will have significant health benefits for the citizens of Europe. - To support smoking cessation efforts and reduce smoking rates throughout Europe. - To establish a European Network of Quitlines. - To organise a European Quitline Conference in Barcelona. - To share expertise/experience of running quitlines. - To raise the standards of such services to help more smokers in Europe in their cessation efforts. - To assist those wishing to establish new quitlines in member states. - To examine the range of practice and evidence of success in different states and disseminate this information.
Outcomes of the project Final report(110KB)

Title of Project RÉSEAU EUROPÉEN HÔPITAL SANS TABAC (HEST)
Organization Name: ASSISTANCE PUBLIQUE - HÔPITAUX DE PARIS Address: 3 Avenue Victoria F-75100 RP - PARIS Telephone / Fax: ( + 33-1 ) 40 27 39 94 / ( + 33-1 ) 40 27 32 40 Web site: E-mail: anne-marie.schoelcher@sap.ap-hop-paris.fr Contact person: Doct CARMELITA STOFFELS	Partner Countries A,B,DK,E,F,FIN,I,IRL,L,P,S,UK
Start of Project 1/05/2000	Duration of Project (months) 12
Project Objectives and Action Plans Le Réseau Européen Hôpital Sans Tabac ( REHST) a été officiellement crée en 1998. Six états membres sont à l'origine de cette action. La France assure la coordination du réseau, elle est aussi l' "initiatrice" d'actions d'envergure européenne financées par la Commission Européenne dans le cadre du programme l'Europe contre le Cancer. L'objectif de ce second projet est de poursuivre et développer les actions mises en oeuvre lors de la mise en place du réseau européen et d'augmenter le nombre de partenaires pour sensibiliser de nouveaux hôpitaux en Europe ( +100 ) afin de contribuer à faire régresser le tabagisme. En effet, l'hôpital est un modèle de santé en général. Ainsi les objectifs complémentaires sont: - de développer le rôle et les actions des hôpitaux européens en matière d'arrêt du tabagisme. - de mettre en oeuvre la charte européenne " Hôpital sans Tabac " élaborée en 1998 moyens et à différents niveaux, elle est inégalement développée. Les réseaux et autres associations en particuliers les ONG, ( Ligue contre le Cancer ) sont engagés dans la promotion de la santé en général. Le but est de fédérer tous les hôpitaux et d'intégrer les actions de prévention du tabagisme dans un seul réseau utilisant des méthodes et des outils communs, comme la charte hôpital sans tabac ( Annexe 1 ). Depuis 1998, une première étape a été atteinte par la construction du Réseau Européen Hôpital Sans Tabac avec 6 puis 7 Etats Membres. Deux manuels pour l'arrêt du tabagisme ont été développés au niveau des états membres, ces manuels comme d'autres outils doivent être évalués et mis en oeuvre par le réseau lors de ce second projet. De plus des conférences de consensus sur les méthodes d'aide à l'arrêt du tabac ont été organisées en France et au Royaume-Uni, leurs recommandations doivent être mises en oeuvre. The European Smokefree Hospital Network ( ESHN ) was officially set up in 1998. Six Member States were responsible for the network being set up. France is the coordinating partner in the network and is also the initiator of European-scale measures funded by the European Commission as part of the Europe Against Cancer programme. The aim of the second project is to pursue and develop the measures introduced when the European network was set up, to increase the number of partners and to raise awareness in new hospitals in Europe ( more than 100 ) so that tobacco smoking can be reduced. In effect, a hospital is a health model in general terms and what hospitals do can influence the way the population at large behaves. The supplementary aims are: - to develop the role and work of European hospitals aimed at suppressing the smoking of tobacco. - to launch the European charter " Smokefree hospital " developed in 1998 and at different levels, the charter not having developed equally well everywhere. The networks and other associations, in particular the NGOs ( anti-cancer associations) are active in the promotion of health in general. The objective is to involve all the hospitals and bring together all the anti-smoking measures into a single network using common methods and tools, such as the European smoke-free hospital charter ( Annex 1 ). Since 1998 the building of the European smoke-free hospital network has successfully completed Stage 1, having initially had six, then seven, Member States involved. Two guides for stopping smoking have been produced at Member State level and these guides as well as other tools must be evaluated and made available via the network as part of the second project. Consensus conferences on ways of helping people to stop smoking have also been organised in France and the United Kingdom and their recommendations need to be put into practice.
Outcomes of the project Executive summary of the final report(380KB) Final report (180KB)

Title of Project INTERNATIONAL NETWORK OF WOMEN AGAINST TOBACCO - EUROPE
Organization Name: HEALTH EDUCATION AUTHORITY Address: 30 Great Peter Street - Trevelyan House UK-SW1P 2 HW - LONDON Telephone / Fax: ( + 44-171 ) 222 5300 / ( + 44-171 ) 413 8906 Web site: E-mail: paul.lincoln@hea.org.uk Contact person: Mr PAUL LINCOLN	Partner Countries A,B,D,DK,E,EL,F,FIN,I,IRL,L,NL,P,S,UK
Start of Project 1/06/2000	Duration of Project (months) 12
Project Objectives and Action Plans The number of Female deaths caused by smoking in the European Union rose from 10000 in 1995 to 49000 in 1975 to 113000 in 1995. Lung Cancer is rising mora rapidly among women than among men in the European Union. Total deaths of llung cancer deaths among men rose from 107 056 to 140 782 between 1973 and 1992 while deaths women nearly doubled this trend. Tobacco use by women and uptake by girls is growing in many parts of Europe. In most countries girls are smoking more than boys. Women tend to smoke different tobacco products than men. In 1995, in the European Union, 48% of all women cigarettes smokers ( some 20 million ) reported smoking " Light " cigarettes. Several surveys have indicated that smokers switching to light cigarettes do so in the belief that these cigarettes are safer. The health risks, however, from smoking low tar brands may be as high as for regular cigarettes. Inwat Europe proposes: To contribute to the reduction of tobacco use among women in Europe by developing the International Network of Women Against Tobacco in Europe, and using it: - to raise awareness of women's tobacco control issues in Europe - to promote communication and exchange of information. - to support existing structures and where necessary develop new ones for the widening of possible consensus on the main elements of a women-centred tobacco control strategy for Europe and promote evidence based, gender sensitive tobacco control strategies and programmes in Europe.
Outcomes of the project Final report (100KB)

Title of Project DEVELOPMENT OF TOBACCO CONTROL TRAINING PROGRAMS FOR EUROPEAN DENTISTS BASED ON ANALYSIS OF THEIR TOBACCO CONTROL ATTITUDES AND PRACTICES
Organization Name: UNIVERSITY OF HELSINKI Address: POB 33, Yliopistonkatu 4 FIN-00014 - HELSINGIN YLIOPISTO Telephone / Fax: ( + 358-9 ) 191 22519 / ( + 358-9 ) 191 23077 Web site: E-mail: anja.ainamo@helsinki.fi Contact person: RAIJA SOLLAMO	Partner Countries A,B,D,DK,E,EL,F,FIN,I,IRL,L,NL,P,S,UK, IN
Start of Project 15/06/2000	Duration of Project (months) 12
Project Objectives and Action Plans Tobacco use, particularly cigarette smoking, is the single largest cause of preventable morbidity and mortality in Europe. Smoking is known cause cancer, hearth disease, stroke and chronic obstructive pulmonary disease. Tobacco smoking is surprisingly prevalent, given the health danger it presents and to public's awareness of those dangers. Furtherlore, smoking prevalence among children and adolescents and women appears to be rising. This ensures that a new generation will be addicted to nicotine and will be at risk for harmful consequences of tobacco use. Most tobacco users have a difficult time stopping because of a combination of physiological addiction to nicotine, a psychological dependence on smoking or spitting yobacco, and a behavioural component that links their tobacco use with specific activities. Although all patients who smoke may not be addicted to nicotine, all patients who smoke should be identified and appropriate treatment steps taken to assist them in the process smoking cessation. Despite the tragic health consequences of smoking physicians, dentists and other health care professionals often fail to assess and treat tobacco use consistently and effectively. However, evidence suggest that tobacco use presents a rare confluence of circumstances (1) a highly significant health treat, (2) a disinclination among the health professionals to intervene consistently and (3) the presence of effective, preventive interventions. Oral health care professionals are uniquely posed to assist patients who smoke in that they have an extraordinary access to population. At least 70 percent of smokers see their dentist every year. This program aims to educate all the European dentists the basic set of steps to help patients to stop smoking and to emphasize the important role health professionals can play in reducing future disease and death rate caused by tobacco addiction.
Outcomes of the project Executive summary of the final report(110KB) Final report (150KB)

Title of Project EUROPEAN CONFERENCE AND EUROPEAN STATUS REPORT ON SMOKING IN THE WORKPLACE
Organization Name: EUROPEAN NETWORK FOR SMOKING PREVENTION Address: 48, rue de Pascale B-1040 - BRUSSELS Telephone / Fax: ( +32-2 ) 230 65 15 / ( +32-2 ) 230 75 07 Web site: E-mail: info@ensp.org Contact person: Prof ALBERT HIRSCH	Partner Countries B,D,DK,E,NL, PL, RO
Start of Project 15/06/2000	Duration of Project (months) 12
Project Objectives and Action Plans In order to assess the current situation in Europe as a basis for future action it is proposed to organise a European conference and a European status report on the situation of smoking in the workplace in the 15 EU Member states, Romania and Poland. Tha aim is to increase the understanding, show the necessity, demonstrate the benefit/feasibility of smoke free workplaces to all players. Specific aims are to: assemble scientific proof of health consequences of smoking in the workplace with an emphasis on passive smoking, inform about current legislation and legal practice, review action plans/programmes/policies dealing with smoking and work places, demonstrate cost-benefit of smoke free workplaces, develop recommendations for governmental/company policy on smoking in the workplace on national and European level. Smoking in the workplace has been identified as a major priority for action on European level by the members of the European Network for Smoking Prevention. This conference would be considered as a follow up of the conference on "A healthy company " organised on 29/30 September 1994 by the German Cancer Society in Berlin ( annexe A ) and explore specifically the "smoking in the workplace" component of health promotion in the workplace. The project is furthermore based on Eurobarometer survey of September 1995 section 3.4.3. ( annexe B ) and the European Report " Passive Smoking the health impact" ( 96 CAN 47782 ) . The European status report will be complementary and developed in synergy with the project " Eurolego " ( VF2-97 CAN 48855 ) and with Activity 3 of the WHO European Partnership project on Tobacco Dependence ( annexe C ) which allows to include Poland in the project. The report of the European Age,cy of Safety and Health in Bilbao on " Priorities and Strategies in Occupational Safety and Health Policy in the Member States of the EU " has been considered in the development of this project ( www.eu-osha.es ) The European Foundation for the Improvement of Living and Working Conditions in Ireland has been contacted and has indicated that no relevant research was so far conducted in the sector ( eurofound.europa.eu ).
Outcomes of the project Final report(100KB)

Title of Project OPERATION OF EUROPEAN TOBACCO CONTROL NETWORK 2000
Organization Name: EUROPEAN NETWORK FOR SMOKING PREVENTION Address: 48, rue de Pascale B-1040 - BRUSSELS Telephone / Fax: ( +32-2 ) 230 65 15 / ( +32-2 ) 230 75 07 Web site: E-mail: info@ensp.org Contact person: Prof ALBERT HIRSCH	Partner Countries A,B,D,DK,E,EL,F,FIN,I,IRL,L,NL,P,S,UK
Start of Project 15/09/2000	Duration of Project (months) 15
Project Objectives and Action Plans The European Network for Smoking Prevention ( ENSP ) has been set up as an international non profit association with the specific mission to develop a strategy for co-ordinated action among organisations active in tobacco control in Europe. Our objective has txo major axes: 1) to operate and strengthen a European network representative of non for profit organisations active in tobacco control in Europe, to intensify exchange of information and experience, to support the development of effective legislation on national and European level, to create interaction and synergy between non-governmental and intergovernmental organisations' activities in tobacco control and to actively support the work of organisations in the EU accession countries and facilitate transfer of technology . 2) to co-ordinate and manage large scale, cost-effective European smoking prevention projects by organising European framework grant applications.
Outcomes of the project Executive summary of the final report(140KB) Final report (330KB)

Title of Project EUROPEAN WEEK AGAINST CANCER 2000
Organization Name: CANCER SOCIETY OF FINLAND Address: Liisankatu 21 B FIN-00170 - HELSINKI Telephone / Fax: ( + 358 ) 9135331 / ( + 358 ) 91351093 Web site: E-mail: liisa.elovainio@cancer.fi Contact person: LIISA ELOVAINIO	Partner Countries A,B,D,DK,E,EL,F,FIN,I,IRL,L,NL,P,S,UK, HR, CZ, EE, HU, IL, PL, SK, CH, IS, NO
Start of Project 1/01/2000	Duration of Project (months) 12
Project Objectives and Action Plans There are various national and international guidelines and recommendations concerning nutrition and cancer. This project will promote ways to implement them in everyday life in different countries. The project will base mainly on the facts presented in the publication of the World Cancer Research Fund/American Institute for Cancer Research ( 1997 ) and the European Code Against Cancer. It will also utilise the UICC statement on Diet, Nutrition and Cancer Control 1998 ( Annexe 2 ) and the recommendations of the European Commission concerning nutrition ( foreseen to appear in the year 2000 ) . The project relates to the knowledge about the various ways how nutrition may affect the process of cancer development, carcinogenesis: 1. Dietary factors themselves can be part of the causal pathway ( e.g. alcohol ). 2. Carcinogenic compounds can be present in food due to spoilage or contamination ( e.g. myvotoxins ). 3. Certain cooking methods can generate carcinogenic chemicals into food ( e.g. PAH's in grilling ). 4. Carcinogenic substances can be formed in the body from dietary constituents ( e.g. N-nitroso compounds from nitrates and nitrites ). 5. Nutritional factors may inhibit carcinogenesis or their low intake may increase the risk of cancer ( e.g. trace elements in fruits and vegetables ). The project aims are the follow: 1. To increase the awareness of the relation between nutrition and cancer. 2. To encourage the Europeans to adopt a healthy diet. 3. To increase the skills of the Europeans to keep to a healthy diet in their everyday lives: preparing of healthy meals, choosing healthy foodstuffs, etc..

Title of Project RADIOLOGICAL RISK ASSESSMENT IN A BREAST CANCER SCREENING PROGRAMME
Organization Name: DIRECCION GENERAL PARA LA SALUD PUBLICA CONSELLERIA DE SANIDAD GENERALITAT VALENCIANA Address: Micer Masco n° 31 E-46 010 - VALENCIA Telephone / Fax: 34 96 38 66 011 / 3496 3869233 Web site: E-mail: lsalas@san.gva.es Contact person: Dr FRANCISCO J. BUENO CAÑIGRAL	Partner Countries E
Start of Project 1/01/2000	Duration of Project (months) 12
Project Objectives and Action Plans Members from Conselleria de Sanidad (Regional Health Government), from "La Fe" Hospital and from Nuclear Engineering Department of Polytechnical University of Valencia, have set up a multidisciplinary research group. They have carried out some research studies related to physic in mammography since 1998. Consequently, the group has produced some scientific publication as an article for the Ninth International Conference on Radiation Shielding in Japan (ICRS-9) entitled "Mammographic Dosimetry using MCNP-4B" and an abstract submitted to the Tenth International Congress of the International Radiation Association (IRPA-10) entitled "Radiological Risk Assessment in a Breast Screening Programme". The objectives of the present project are: 1 .A pilot project of Quality Assurance to increase the number of detected cancers. The main aim of the project is to reduce radiological risk, evaluating mammography screening centres improvement related to the last quality control and pursuing the optimum cancer detected/cancer induced ratio, all of them related to the Comunidad Valenciana Breast Screening Programme. 2.Identification of the quality image elements and definition of their acceptance range. 3.Results will be disseminated in national and international conferences to be applied in other national breast screening programmes as well as other Member States programmes. 4.A computer tool will be developed in order to be a didactic material for radiologist and technical engineer. It will include results from the study.

Title of Project COMPARING BREAST CANCER SURVIVAL IN EUROPE AND IN THE USA
Organization Name: ISTITUTO NAZIONALE PER LO STUDIO E LA CURA DEI TUMORI Address: Via Venezian, 1 I-20133 - MILANO Telephone / Fax: +39/02/23902460 / +39/02/23902762 Web site: E-mail: gatta@istitutotumori.mi.it Contact person: Dr GIOVANNI LOCATELLI eurocare@istitutotumori.mi.it	Partner Countries A,DK,E,F,FIN,I,NL,S,UK, IS, EE, PL, SI, CH
Start of Project 1/06/2000	Duration of Project (months) 12
Project Objectives and Action Plans Through EUROCARE (a European Concerted Action started in 1990), 45 European CR in 17 countries gathered their survival data of patients diagnosed from 1978 to 94, in a common data base, with the aim to standardise data collection, disease definition and to uniformely analyse survival with the same statistical methods. Detailed information on diagnostic and therapeutic procedures for patients diagnosed in 1990-94 are available on a sample basis.The SEER project made available individual survival data on CDrom, allowing direct survival analysis for research aims. These data are collected with standard methods from 10 CRs, covering 10% of the US population, for patients diagnosed from 1973 to 1995. Since 1983 data on stage and therapy are also available. Comparisons between EUROCARE and SEER highlighted a higher survival for breast cancer (BC), in the US than in Europe: 5year relative survival of patients diagnosed in 1985-89 was 73% in Europe and 82% in the US. Large intercountry survival differences were found within Europe, but in all countries survival was lower than in the US. The differences were more marked in the elderly, patients aged 75+ had nearly 20% higher survival in US than in Europe. A part of these differences between Europe and US can be related to methodological aspects (proportion of patients lost at follow-up, DCO, microscopic verification, methods of statistical analysis) that are to be deeply considered in the comparisons; but actual survival differences can be due to different patterns of care. Higher survival in the US than in Europe can be related to a higher proportion of tumours at limited stage, due to a more intensive diagnostic activity. Stage specific or stage-adjusted survival comparisons can be misleading, since staging depends on the throroughness of diagnostic investigations. For proper stage-adjustments it is necessary to take into account also the exams performed for staging. For BC, the number of examined lymph-nodes during a lymphadenectomy is a main determinant of stage, since the N category depends on it. Previous studies reported an increase of the risk of death after five-six years since diagnosis, that has been related to the occurrence of relapse. The comparison of the pattern of death hazard in European and US patients is useful to understand the natural history of the disease and to integrate the study on survival. Aim of the study: to understand the reasons for the lower survival for breast cancer in Europe compared to the United States, using data of population-based cancer registries (CRs) of the EUROCARE and of the US SEER networks. Principal issues to be addressed by the study are: - Pattern of survival by age, focusing on the particularly lower survival of elderly patients in Europe compared to the US. - Proportion of tumours at localised stage in Europe and US, and evaluation of its influence on survival, through proper stage-adjusted survival comparisons. - Pattern of death risk during years following the diagnosis of breast cancer in Europe and US, including long term survivors.

Title of Project EUROPEAN CONSENSUS CONFERENCE ON PRIMARY AND SECONDARY PREVENTION OF SKIN CANCER
Organization Name: EUROPEAN SOCIETY OF SKIN CANCER PREVENTION E.V. EUROSKIN Address: c/o Am Krankenhaus 1 D-21 614 - BUXTEHUDE Telephone / Fax: 49 4161 703 6991 / 49 4161 703 6745 Web site: E-mail: euroskin@t-online.de Contact person: Dr ECKHARD WILHELM BREITBART	Partner Countries D,F,FIN,I,NL,S,UK
Start of Project 1/01/2000	Duration of Project (months) 12
Project Objectives and Action Plans The incidence of non-melanocytic skin cancers ( squamous cell carcinoma, basal cell carcinoma ) and malignant melanoma of the skin has increased drastically in Europe over recent decades ( doubling every 10-15 years ). According to a large number of epidemiological and experimental in vitro and in vivo studies, this is largely due to changes in the leisure behaviour of the European population. This is characterised by increased exposure to UV radiation from natural ( sun ) and artificial UV sources, accompanied by the conviction that a tan expresses health and wellbeing. It is now well-established that the cumulative UV dose and intermittent strong UV exposures ( sunburn ), particularly in early chilhood, are the main risk factors in the occurence of squamous cell carcinoma and malignant melanoma, respectively. Basal cell carcinoma occupies an intermediate position in the respect. The aetiology of non-melanocytic skin cancer and malignant melanoma is currently the subject of intensive research. As early as 1994, a consensus paper for Europe as awhole was prepared on "How to decrease morbidity and mortality of skin cancer " with the aim of countering the above-mentioned trend in the incidence of skin cancer. In the light of new findings, however, additional approaches the primary and secondary prevention need to be discussed and planned. This can be accomplished successfully and efficiently only through joint, harmonised action at European level. The " European Society of Skin Cancer Prevention, EUROSKIN " was accordingly founded in May 1999. The aim of the intended project is to gather together, at a symposium organised by EUROSKIN. " European Consensus Conference on Primary and Secondary Prevention of Skin Cancer " new findings in the primary and secondary prevention of skin cancer and arrive at a consensus for a future approach at European level. On the basis of the consensus established will be followed up by the planning of joint measures with the participation of European countries.

Title of Project EUROPEAN NETWORK OF CANCER REGISTRIES (ENCR)
Organization Name: INTERNATIONAL AGENCY FOR RESEARCH ON CANCER Address: 150, cours Albert-Thomas F-69372 - LYON CEDEX 08 Telephone / Fax: ( + 33-472 ) 73 8485 / ( + 33-472 ) 73 8575 Web site: E-mail: Riboli@iarc.fr Contact person: Dr PAUL KLEIHUES	Partner Countries A,B,D,DK,E,EL,F,FIN,I,IRL,L,NL,P,S,UK
Start of Project 1/06/2000	Duration of Project (months) 12
Project Objectives and Action Plans Information on the occurrence and outcome of cancer is relevant not only to the scientific community (whose main interest lies in determining causes of cancer), but also to public health planners, who are concerned with setting priorities, deciding future requirements for and evaluating the effectiveness of cancer control measures (prevention, screening, therapy). Cancer information systems, and in particular cancer registries, have developed on a regional or national basis in the countries of the EU over the last 50 years. During this time, national associations of registries have developed to ensure coordination of activities within individual countries, along with some regional groupings (Association of Nordic Cancer Registries, Latin Languages Cancer Registry Group, etc.). However, in contrast to other regions of the world, particularly North America, a wider focus for the coordination of activities did not exist until the establishment of the European Network. Obtaining valid and comparable information on cancer incidence, survival, and prevalence on a Europe-wide basis was therefore difficult. The activities of the ENCR contributes greatly to improving this. The objectives of this project are: - to increase the quality and comparability of data on cancer incidence and outcome in the EU; - to extend the availability of such data by encouraging population-based cancer registration within the EU; - to promote the use of cancer registry data in Europe; - to provide an information system for monitoring cancer occurrence (incidence, survival, prevalence) in the countries of the EU, including regular dissemination of information; - to provide a computer program package for the analysis of time trends of cancer incidence and mortality in the countries of the EU; - to provide training, consultantship and information exchange activities. The Network comprises members from all countries of the EU. Members have access to all ENCR activities and have the opportunity to participate in European collaborative projects.

Title of Project MORQA (REDUCTION OF RADIATION MORBIDITY THROUGH QUALITY ASSURANCE, DOSIMETRY AND EVALUATION OF MORBIDITY)
Organization Name: EUROPEAN SOCIETY FOR THERAPEUTIC RADIOLOGY AND ONCOLOGY (ESTRO) Address: Av. E. Mounierlaan, 83/4 B-1200 - BRUSSELS Telephone / Fax: +32/2/7759340 / +32/2/7795494 Web site: E-mail: ab6d@udcf.gla.ac.uk Contact person: Prof ANN BARRETT ab6d@udcf.gla.ac.uk	Partner Countries B,D,E,F,FIN,I,NL,S,UK
Start of Project 1/03/2000	Duration of Project (months) 12
Project Objectives and Action Plans The outcome of radiotherapy is very much dependent on the dose level used in the treatment. A too high dose might result in serious morbidity, on the other hand a too low dose might instead result in recurrence of the tumour. The optimal level is often in a small " window " and is related to a number of parameters such as the type of tumour, its volume, value of normal tissue irradiated, fractionation scheme etc. Most radiotherapy related morbidity is caused by unintended delivery of dose to the healthy tissue above the known level of tolerance. The aim of this project is to reduce the morbidity after radiotherapy while at the same time persevering or increasing the probability of local control of the tumour ( preventing recurrencies). One common reason for an inadequate dose to the tumour region or the healthy tissue is that the stated dose is, in reality, not the dose delivred. This might be due to the possible variations in the dosimetry procedure. The first goal ( task 1 ) is therefore to introduce a dosimetry check system in Europe. Feasibility studies carried out through EU support have shown that such a system could be based on postal TL- dosimetry. Such checks are planned to be made available to all radiotherapy departments in the EU. For radiotherapy given the limits of tolerance, a certain degree of morbidity can be accepted, usually scoring grade 1 or grade 2 on the scales of late radiation toxicity. Grades 3 and 4 should be relatively rare events in treated patients and should, theoretically, only be seen in the extremes in the variation in patient radiosensitivity . The second goal (task 2 ) is to investigate whether frequencies of grades 3 and 4 late radiation toxicity clusters can be related to specific medical protocols, processes or applications. The combination of task 1 with task 2 allows to exclude significant dose errors as a possible cause of complications. It is estimated that a reduction of the complication rate with 30-50% would be possible in a period of 3 years. Task 1 and 2 together also provide the basis for further optimisation of radiotherapy regimes e.g. dose escalation with conformal radiotherapy (CRT). It is of great importance that basic data on morbidity related to dose level are available in dose escalation using CRT or intensity modulated CRT. Many centres in the EU are now introducing novel technology making such optimisation possible. Some optimised procedures will be studied. Proper use of such advanced techniques will certainly improve considerably both the outcome of radiotherapy and its cost effectiveness.

Title of Project QUALITY ASSURANCE AND CONTROL IN CERVICAL CYTOLOGY IN SLOVENIA
Organization Name: INSTITUTE OF ONCOLOGY Address: 2/ Zaloska SI-1000 - LJUBLJANA Telephone / Fax: (+386) 1 43 14 225 / (+386) 1 13 14 180 Web site: E-mail: zrudolf@onko-I.si Contact person: Prof ZVONIMIR RUDOLF zrudolf@onko-I.si	Partner Countries B,D,EL,F,I,NL,UK
Start of Project 1/09/2000	Duration of Project (months) 12
Project Objectives and Action Plans The project is part of the European Network for Cervical Screening, topics '' Quality Assurance and Quality Control ''. With respect to Slovenia, the country has not been a member of this network till now, but a pilot study of organised cervical screening started in its central region in 1998, following the fact that despite extensive opportunistic screening the incidence of invasive cervical cancer in 1982 reached its plateau ( about 16.1/100.000), and moreover, an increase in the age group 25-54 has been observed in the past years . One of the aims of the pilot project is the development of national standards for quality assurance and control in cytology laboratories. The aim of this project is the evaluation and further development of the recommendations and guidelines for quality assurance in cytology laboratories according to local experiences and developments in countries participating in the netxork to further improve the performance of cervical cytology in Slovenia by : - evaluation of performance of four cytology laboratories, reading smears from women included in the pilot study of organized cervical screening in Slovenia. - evaluation and, where necessary, revision of existing guidelines for reporting cervical smears. - proposing standard ranges for reporting negative, inadequate and abnormal categories of cervical smear.

Title of Project EPIDEMIOLOGY OF CERVICAL CANCER AND EVALUATION OF CERVICAL SCREENING IN SLOVENIA
Organization Name: INSTITUTE OF ONCOLOGY Address: 2/ Zaloska SI-1000 - LJUBLJANA Telephone / Fax: (+386) 1 43 14 225 / (+386) 1 13 14 180 Web site: E-mail: Contact person: Prof ZVONIMIR RUDOLF zrudolf@onko-I.si	Partner Countries B,EL,F,I,NL,S,UK
Start of Project 1/09/2000	Duration of Project (months) 12
Project Objectives and Action Plans The project is part of the European Network for Cervical Screening topics ''Monitoring,Epidemiology and Evaluation of Cervical Screening''. With respect to Slovenia, the country has not been a member of this network till now. Data on the evidence of intraepithelial and invasive cervical cancer, provided by one of the oldest cancer registries in Europe covering the whole country, and mortality statistics can be used to evaluate the effectiveness of the opportunistic screening programme that started in 1960. In the frame of the pilot study of organized cervical screening in the central region of Slovenia, a Smear Registry was established in 1998. Individual and statistical data provide the basis for monitoring the effectiveness of the existing screening activity in the whole country and the spontaneous cervical screening with the screening by invitation in the pilot region. The aim of this project is the evaluation of the effectiveness of the cervical cancer screening programme in Slovenia and further development of its monitoring system by : - detailed analysis of the incidence and mortality from invasive cervical cancer in different age groups and regions of Republic of Slovenia in the last three year period. - detailed analysis of the uptake of spontaneous screening in the central region of Slovenia in the period 1998-1999 from the data from the Smear Registry in this region. - detailed analysis of the uptake of screening by invitation of the sample of women aged 25-64 included in the pilot study of organised screening the period 1998-1999. - establishing the linkage of the Smear Registry to the Cancer Registry of Slovenia - evaluation of indicators for process evaluation of cervical screening programme,including parameters by EC guidelines to determine effectiveness and costs of screening.

Title of Project TO STRUCTURE A COMPUTERISED SCREENING MAMMOGRAPHY TEACHING FILE FOR TRAINING AND EVALUATION OF THE READERS
Organization Name: DIRECCION GENERAL PARA LA SALUD PUBLICA CONSELLERIA DE SANIDAD GENERALITAT VALENCIANA Address: Micer Masco n° 31 E-46 010 - VALENCIA Telephone / Fax: 34 96 38 66 011 / 3496 3869233 Web site: E-mail: lsalas@san.gva.es Contact person: Dr FRANCISCO J. BUENO CAÑIGRAL	Partner Countries E
Start of Project 1/01/2000	Duration of Project (months) 12
Project Objectives and Action Plans The screening mammography reading precise a specific educational method and a quality control process. A continuous performance should be maintainted by means of the dedicated mammography educational courses and the evaluation and certification of the acquired knowledge in a validated reading system (1,2,3,4). The purpose of this project is to create and to structure a screening mammography teaching file.This system can provide a method to perform a continuous training and to allow the evaluation of the readers in the screening mammography.The radiologist will be able to receive the corresponding accredited certification if they pass the examination.The overall teaching file will be extracted from the original mammograms of the Valencia Breast Cancer Screening program (VBCSP) in the Valencia Community-Spain (more than 300.000 screened women). The inclusion of the teaching file cases in a computer support (CD-ROM) will supplement their didactic use and will permit an extensive diffusion (5). As derived objective an improvement in the readers will be achieved which will have a positive effect in the early breast cancer diagnoses and therefore in the mortality reduction, main objective of the screening programs. 1. Kirkpatrick A. Törnberg S. Thijssen MAO. European Guidelines for quality assurance in mammography screening (Final Report). Luxembourg 1993. EUR 14821. 2. Vizcaino I, Salas D, Vilar JS, Ruiz-Perales F, Herranz C,Ibañez J.Breast cancer screening: first round in the population-based program in Valencia, Spain. Radiology 1998, 206:253-260. 3. American College of Radiology (ACR).Breast Imaging reporting and data system (BI-RADStm) .Third Edition .Reston ( VA): American College of Radiology,1998. 4.Linver MN, Paster SB, Rosenberg RD, Key CR, Stidley CA, King WV.Improvement in mammography interpretation skills in a community radiology practice after dedicated teaching courses: 2- year medical audit of 38,633 cases. Radiology 1992; 184:39-43. 5.Smathers RL.Mammography CD-ROM. Lippincot-Raven Publishers 800-777-2295.

Title of Project PUBLIC HEALTH AND CLINICAL SIGNIFICANCE OF PREMALIGNANT ALTERATIONS IN THE GENITO-URINARY TRACT
Organization Name: WHO COLLABORATING CENTER FOR UROLOGIC TUMORS Address: karolinska hospital S-171 76 - STOCKHOLM Telephone / Fax: 46/8/662.38.00 / 46/8/662.11.12 Web site: E-mail: Lennart.Andersson@kirurgi.ki.se Contact person: Prof LENNART ANDERSSON	Partner Countries B,D,E,I,NL
Start of Project 1/01/2000	Duration of Project (months) 12
Project Objectives and Action Plans The number of people developing cancer increases dramatically. In many European countries, cancer in the genito-urinary organs, in particular prostate and urinary bladder cancer, are a heavy burden to the Health Services. The effect of treatment has not improved very much. New avenues have to be assayed to challenge the increasing cancer morbidity. Premalignant lesions, and even preinvasive cancer, is presumably much more accessible to curative treatment than clinically overt cancer, and most desired are preventive measures, primary or secondary. The present knowledge of premalignant lesions is incomplete and inadequate. The aim of the project is systematic evaluation of premalignant alterations in the genito-urinary organs and of their clinical relevance. Methods to detect and to treat them will be designed. Epidemiologic research will focus on cancer promoting factors, with the aim to design preventive peasures. The faculty is in possession of adequate expertise to analyse these matters to the limits of science at present.

Title of Project COMBINED STUDY. PAP SMEAR BY THE THINPREP METHOD AND HPV TESTING IN SMEARS CLASSIFIED IN ASCUS/AGUS WITH THE OBJECTIVE OF OBTAIN CRITERIA IN ORDER TO DETERMINE FOLLOW- UP
Organization Name: CENTRO REGIONAL DE ONCOLOGIA DE COIMBRA DO INSTITUTO PORTUGUES DE ONCOLOGIA DE FRANCISCO GENTIL Address: Avenida Bissaya Barreto, N° 98 - Apartado 2005 P-3003 - COIMBRA CODEX Telephone / Fax: +351/39/400309 / +351/39/484317 Web site: E-mail: Contact person: Dc MANUEL SILVA	Partner Countries P
Start of Project 1/02/2000	Duration of Project (months) 12
Project Objectives and Action Plans Despite the growing number of Pap tests performed annualy, which has contributed to a reduction of between 50 and 70 % in the incidence of cervical cancer, the incidence rates are still significant high. The Pap smear has its limitations and there is a significant number of false negatives, even in countries with well organized screening programmes.Thus number of equivocal cases diagnosed is significant , which leads to excessive in the follow-up of women. The percentage of smears with atypical undetermined significance ( ASCUS or AGUS) is 60/70 % of all abnormal cytology. ASCUS cytology represents a serious problem for the clinician who works that this diagnosis conceals a significante rate, about 10 %, of high Grade Lesion (HSIL). Some authors admit that more than 50 % of colposcopies are performed after a cytological diagnosis of ASCUS and that some of these women have a pre-cancerous lesion. The clinical management of these women is currently much debated. Epidemiological and molecular biological studies have shown that infection with high risk HPV, is an etiological factor in the pathogenesis of cervical cancer. The progression of pre-malignant lesions is associated with the continuous presence of high risk HPV types. No progression is associated in the absence of high risk HPV types or the presence of non-high risk HPV'S. The absence of high-risk HPV in this type of alterations permits the exclusion of nine out of ten serious cervical lesion, while the detection of high-risk HPV DNA predicts no underlying lesion seven times out of ten. The aim of this project is to undertake a combined study, Pap smear by thin Prep Method and HPV testing, over a period of a year on women whose first cytological test will be done within the Cervical Cancer Screening Programme of the Central Zone of Portugal, and whose smears result in the cytological diagnosis of ASCUS/AGUS. The objective is to find criteria for the selection of patients to be referred for colposcopy, in order to establish a suitable follow-up avoiding over-diagnosis and unnecessary treatment , thus making the process more cost-efficient.

Title of Project THE EFFECT OF HELICOBACTER PYLORI ERADICATION AND OR ASCORBIC ACID SUPPLEMENTATION ON THE RATE OF CHANGE OF PRECANCEROUS GASTRIC MUCOSAL LESIONS
Organization Name: EUROPEAN CANCER PREVENTION ORGANISATION, LADY SOBELL GASTROINTESTINAL UNIT Address: Wexham Park Hospital UK-SL2 4HL - SLOUGH,BERKS Telephone / Fax: +44/1753/634153 / +44/1753/511835 Web site: E-mail: BELINDA@ASIL.co.uk Contact person: Mrs BELINDA JOHNSTON Belinda.Johnston@hwph-tr.anglox.nhs.uk	Partner Countries E,FIN,IRL,NL,P,UK, HU, PL
Start of Project 1/01/2000	Duration of Project (months) 12
Project Objectives and Action Plans It is known that there is a definite sequence of cellular changes from H.pylori induced gastritis, atrophy, intestinal metaplasia, dysplasia to gastric cancer. Since the mortality from gastric cancer is high and it is still one of the commonest cancers seen in member countries, it would be of great importance if progression along this histopathological pathway could be stopped or reversed and gastric cancer incidence thereby reduced. The project is based on the results of an earlier European multi-national study by ECP which showed that patients with gastric intestinal metaplasia had higher carriage rates of H.pylori, lower intake of foods containing vitamin C and lower serum ascorbic acid levels than two groups of age and sex matched controls (patients with normal stomachs and community controls). The aims of this study therefore are to see if either H.pylori eradication or long-term supplementation of the diet with vitamin C or a combination of the two will alter the rate of change of intestinal metaplasia.

Title of Project EUROPEAN PROSPECTIVE STUDY OF BRCA 1/2 GENE CARRIERS
Organization Name: INTERNATIONAL AGENCY FOR RESEARCH ON CANCER/WORLD HEALTH ORGANIZATION (IARC/WHO) Address: 150, cours Albert Thomas F-69372 - LYON CEDEX 08 Telephone / Fax: ( +33-472 ) 73 84 85 / ( +33-472 ) 73 85 75 Web site: E-mail: brennan@iarc.fr Contact person: Dr PAUL KLEIHUES	Partner Countries A,B,D,DK,E,F,I,NL,S,UK, IS, HU
Start of Project 1/03/2000	Duration of Project (months) 12
Project Objectives and Action Plans Breast cancer is the most common cancer affecting women in the EU. Efforts to decrease breast cancer mortality have focused on early detection and improved treatment. Identification of women at particularly high risk of developing the disease provide a group on whom expensive and rigorous screening programs are cost-effective and a cohort of women who may benefit from trials of chemopreventive agents. Although counseling and genetic testing of at-risk women is now underway in many centres in Europe and North America, the risks of cancer provided to gene carriers is based on limited data obtained from retrospective analyses in high-risk research families. Moreover data derived from population-based prevalence surveys have consistently produced lower estimates than those cited above; hence there is a great need for a prospective study of a clinically derived cohort of women to clarify this issue. While several countries have begun national or regional efforts to address these issues prospectively, the sample sizes required for adequate precision and power are often beyond the scope of any one center. Accordingly, there is a clear need for international coordination of these efforts with a standardized enrollment and follow-up protocol, and combined data analyses. Under the auspices of our previous grant from the DG-V programme, we have launched an international observational cohort study of BRCA1/2 mutation carriers (IBCCS) and have now completed work on the central relational database, finalized all necessary questionnaires and protocol documents and have to date enrolled a total of 619 subjects into the study. The study has expanded and now contains 16 participating centers from 10 EC member states and two other European countries. In addition we have established collaborative protocols with similar studies in the USA, Australia, and Canada, which will allow joint analyses of specific hypotheses of interest requiring larger samples sizes than available in any individual data set. The specific aims of the IBCCS study are to: (1) more precisely estimate the age, sex, and site-specific cancer risks due to mutations in the BRCA1 and BRCA2 genes; (2) determine the importance of known reproductive and other lifestyle risk factors in modifying these risks; (3) examine the efficacy of prophylactic surgery and other screening/prevention options in high risk women; (4) create an ongoing registry of gene carriers for, potential use in future clinical trials.

Title of Project DIRECTORY OF ON-GOING RESEARCH IN CANCER PREVENTION
Organization Name: INTERNATIONAL AGENCY FOR RESEARCH ON CANCER/WORLD HEALTH ORGANIZATION (IARC/WHO) Address: 150, cours Albert Thomas F-69372 - LYON CEDEX 08 Telephone / Fax: ( +33-472 ) 73 84 85 / ( +33-472 ) 73 85 75 Web site: E-mail: brennan@iarc.fr Contact person: Dr PAUL KLEIHUES	Partner Countries A,B,D,DK,E,EL,F,FIN,I,IRL,L,NL,P,S,UK
Start of Project 1/07/2000	Duration of Project (months) 18
Project Objectives and Action Plans The Directory is a unique source of information on current work in the areas of primary prevention, chemoprevention and screening, serving the information needs of a targetted audience. While other databases of medical literature contain abstracts of completed published studies, this Directory lists on-going unpublished work only, most of which is not documented elsewhere. The Directory complements currently available information sources, allowing researchers and other users to keep abreast of current directions and trends in cancer prevention research. To our knowledge, there is no other publication of this type. It thus plays an important role in disseminating information not available elsewhere.The aims of the project are: (1) to maintain and update the Directory of On-Going Research in Cancer Prevention, first published in 1999, with the aim to (a) inform researchers, clinicians, public health professionals, policy makers and other interested persons about work being carried out in the field of cancer prevention; (b) encourage, facilitate and stimulate collaboration among researchers with interest in cancer prevention; (c) encourage areas where further work is needed. (2) to disseminate the Directory to a wide audience via Internet; (3) to enhance the use of biological materials banks in cancer prevention research by disseminating information on such banks. The Directory is produced jointly by institutes in two EU Member States (France and Germany). It is a major source for European research workers to obtain information on on-going research in cancer prevention and early detection carried out in the rest of the world. It is also a simple means for European scientists to make their work better known to researchers in the other continents. The Directory will promote collaboration between European research workers and others and provide a comparative evaluation of the work being carried out in Europe and elsewhere. This will also promote new research and utilisation of biological materials banks. With the potential expansion of the EU, it can be expected that the proportion of 'European' projects in the Directory will increase.

Title of Project SERUM COTININE, SMOKING STATUS, PASSIVE SMOKING AND LUNG CANCER RISK IN THE JANUS COHORT
Organization Name: INTERNATIONAL AGENCY FOR RESEARCH ON CANCER/WORLD HEALTH ORGANIZATION (IARC/WHO) Address: 150, cours Albert Thomas F-69372 - LYON CEDEX 08 Telephone / Fax: ( +33-472 ) 73 84 85 / ( +33-472 ) 73 85 75 Web site: E-mail: brennan@iarc.fr Contact person: Dr PAUL KLEIHUES	Partner Countries F,UK, NO
Start of Project 1/01/2000	Duration of Project (months) 12
Project Objectives and Action Plans There is growing evidence that exposure to passive smoking is causally related to lung cancer. The relative risk of lung cancer among individuals exposed to passive smoke is in the order of 1.2-1.4. The available studies are based on self-reported exposure to passive smoking, usually collected via a questionnaire. This approach to assess exposure to passive smoking is subject to misclassification and has been criticized. To date, no epidemiological studies of lung cancer are available in which exposure to passive smoke has been assessed via the measurement of cotinine in the body. Assessment of passive smoke exposure via serum or urinary cotinine is not subject to recall or report bias and integrates all sources of passive smoke. The aims of the project are to measure serum cotinine level in samples of cases of lung cancer and controls enrolled in the Norwegian Janus serum bank, and to analyse the association between cotinine level and lung cancer risk in non-smokers exposed to passive smoke.

Title of Project PAIN MANAGEMENT IN CHILDREN: PSYCHOLOGICAL, MEDICAL AND SURGICAL APPROACH
Organization Name: ONCOLOGY UNIT OF THE PAEDIATRIC CLINIC OF THE UNIVERSITY " LA SAPIENZA " OF ROME Address: 324, Via Regina Elena I-00161 - ROME Telephone / Fax: ( + 39-0 ) 6 49218495 / ( + 39-0 ) 6 49972295 Web site: E-mail: castello@uniromal.it Contact person: Doct MANUEL A. CASTELLO	Partner Countries E,I,UK
Start of Project 1/01/2000	Duration of Project (months) 12
Project Objectives and Action Plans The project aim is to improve the ability to assess childhood cancer pain, especially in pre-verbal children whom communication of discomfort is very difficult. A careful evaluation of pain in childhood is essential for an efficacious care. Infants are generally under-medicated: they are harmed by the use of analgesic and they do not respond to pain as adults do. Actually there are many mistakes in dosage frequency and route of administration. In order to overcome these problems, it has been developed a number of pain scales which rely upon self-reporting or behavioural indices. The Oncology Unit staff of the Paediatric Clinic of the University " La Sapienza " of Rome, in co-operation with two important European Institutes of Paediatric Oncology, has assessed a form for the management of childhood cancer pain. The project task is to analyse all the possible situations of pain in the paediatric age, from the dioagnosis of the illness to its pharmacological and/or surgical cure. It consists on screening the evaluation methods ( self and hetero-evaluation scales ) by age, cultural, social differences in children, and also by the type of pain in order to help sanitary operators to chose the appropriate treatmant plan. According to the World Health Organisation it has been selected a scale of analgesic drugs of appropriate strength to treat the pain. Actually Serum-Endorphin evaluations seem strictly related to pain intensity. Therefore, the innovative aim of the study is to screen SB-E ranges in painless children and irs possible variability with ages, sex, psychic stress, and pain ( acute and chronic ) . The samples will be tested with IRMA ( immuno-radio-monoclonal-antibody ) method ( of Technical Laboratories Instrumental ) . The results will be analysed and compared by statistic tests.

Title of Project IMPROVING HEALTH STAFF'S COMMUNICATION AND ASSESSMENT SKILLS OF PSYCHOSOCIAL MORBIDITY AND QUALITY OF LIFE IN CANCER PATIENTS: A STUDY IN SOUTH EUROPEAN COUNTRIES
Organization Name: UNIVERSITÀ DEGLI STUDI DI FERRARA Address: Via Savonarola, 10 I-44100 - FERRARA Telephone / Fax: ( + 39-0 ) 532 293111 / ( + 39-0 ) 532 247545 Web site: http://www.unife.it E-mail: Contact person: Prof. ADOLFO SEBASTIANI	Partner Countries E,I,P, CH
Start of Project 1/01/2000	Duration of Project (months) 18
Project Objectives and Action Plans Studies investigating the prevalence of mental disorders secondary to cancer show that 40 to 50% of the patients meet criteria for a definite psychiatric diagnosis. Depressive disorders represent one of the most common diagnoses, affecting 20-25 % patients. Severe consequences are determined by psychiatric comorbidity, such as reduction of quality of life, abnormal illness behaviour and impoverishment of coping mechanisms. Despite these data psychological disorders among cancer patients go unrecognized in about 60-70 % of the cases. Thus early identification of symptoms and of predictive factors are important from preventive as well as clinical point of view Studies concerning risk factors indicate that family support represents a key factor in preventing psychological symptoms, particularly depression. The latter finding is of extreme significance in South European countries ( e.g. Italy, Spain, POrtugal ) where the traditional medical practices of non-disclosure to patients about their cancer diagnosis and prognosis could be a major obstacle with regard to adjustment to illness. Studies have demonstrated that the traditional practice of giving family members information not given to patients, is a source of conflict for physicians, patients and relatives. Few data in the literature and no data in South European countries are available about the role of communication within the family in favoring adjustment to cancer and in reducing psychological distress among cancer patients. The present project has the following aims: (i) to investigate psychosocial morbidity among cancer patients and the relationship between morbidity and communication about cancer (e.g. within the family members or other support figures ); (ii) to develop structured training method ( communication skills ) for health professionals to improve their abilities in assessing psychological morbidity among cancer patients and in communicating with the patients in order to ameliorate the quality of care.

Title of Project 5 A DAY, GESUND MIT OBST UND GEMÜSE - KEEPING HEALTHY WITH FRUIT AND VEGETABLES
Organization Name: DEUTSCHE KREBSGESELLSCHAFT E.V Address: Paul Ehrlich Str. 41 D-60596 - FRANKFURT/MAIN Telephone / Fax: ( + 49 ) 696300960 / ( + 49 ) 69639130 Web site: E-mail: prevention@deutsche.krebsgesellschaft.de Contact person: RAINER BREDENKAMP	Partner Countries A,D,E,EL,FIN,S
Start of Project 1/01/2000	Duration of Project (months) 12
Project Objectives and Action Plans Ziele des Projekts: - das vorrangige Ziel des Projekts ist die Förderung eines Bewußtseins über die Zusammenhänge einer gesunden Ernährung und Krebsprävention sowie Prävention von Herz-, Kreislauf - und weiteren zivilisationsbedingten Erkrankungen. - gleichrangig soll die Idee " 5 A DAY " auf breiter Ebene promotet werden, d.h. die Bevölkerung soll informiert und motiviert werden, min. 5 Portionen Obst oder Gemüse täglich zu konsumieren. - das Projekt soll Gesundheits - und Präventivverhalten verändern und dadurch langfristig das Krebsrisiko in der Bevölkerung reduzieren. - Vorrangig sollen bestimmte Zielgruppen (z.B. Eltern ) angesprochen werden. - mit dem Projekt soll die Botschaft des europäischen " KOdex gegen den Krebs " vermittelt werden. Project aims: - The main aim of the project is to promote awareness of the relationship between healthy eating and cancer prevention and the prevention of cardiovascular and other lifestyle-related illnesses. - This will entail getting the "5 A DAY" message across to a wide public, i.e. providing information motivating them to eat at least five portions of fruit or vegetables a day. - The project aims, by changing health behaviour, to achieve a long-term reduction in the cancer risk among the general population. - It is aimed chiefly at specific target groups (e.g. parents ). - the project will promote the message of the " European Code Against Cancer". The " 5 a day " idea has aleady been used successfully in several countries, especially the USA and Canada. We see a great deal of potential for this kind of project in Europe. Surveys of consumers and organisations, for example, suggest that there is considerable. Previous action has not sought such a broad impact. This is set to change with this project. The content and aims of the project is the variety of opportunities it affords for cooperation, including cooperation with interested companies. Implemented effectively, it can make a considerable contribution to promary prevention.

Title of Project EUROPEAN CERVICAL CANCER SCREENING NETWORK 2000-2001
Organization Name: ZYTOLOGISCHES INSTITUT BAYERRISCHE KREBSGESELLSCHAFT E.V. Address: Troger Str. 38 D-81675 - MUNICH Telephone / Fax: 0049-89-4194 350 / 0049 89 41 94 3535 Web site: http://www.cancer-network.de E-mail: office@zytologie.de Contact person: Prof. Ulrich SCHENCK E-mail: ulrich@schenck.de	Partner Countries B, D, FIN, F, GR, I, NL, P, S, SV,UK, SL, HU, RO
Start of Project 30/08/1999	Duration of Project (months) 12
Project Objectives and Action Plans The project will develop, monitor research and implement the co- ordination of activities of a large scale programme, relevant to the field of cervical research and screening which will be methodologically sound and have considerable impact upon health care in the European Union.It will involve both governmental and non-governmental organisations involving 11 organisations from nine Member States and one accession country, all able to demonstrate proof of competence in the field of cervical cancer. Through the operation of a Centre, based in Sheffield, UK the project will : - utilise the European Union pilot network for cervical cancer screening to provide a co-operation programme of projects encompassing evaluation, review and research in line with the objectives of the Europe Against Cancer Programme and to provide for greater Community added value: - provide for a large scale linked project embracing: quality assurance and quality control; monotoring,epidemiology and evaluation of cervical screening results; and new technologies in cervical screening, which will target over 90 million women within nine Member States; With regard to : above the project will assess their impact on mass screening for cervical cancer and set out recommendations of both short term and long term relevance; with regard to : above to help establish the criteria for assessing costs/benefits and negative effects and; with regard to : above to assess these new technologies in the context of cervical cancer screening in terms of sensitivity, specificity, predictive value and reproducibility. - provide for effective dissemination of results and monitoring activity to aim to ensure that this large scale project is capable of application in the remaining Member States and helping to enhance health care throughout the Union.
Outcomes of the project Executive summary of the final report(86KB) Final report, February 2002(2.1MB)

Title of Project EUROPEAN BREAST CANCER SCREENING NETWORK
Organization Name: BUNDESVERBAND DER INNUNGSKRANKENKASSEN Address: Firedrich-Ebert-Str. (Technologie Park) D-51429 - BERGISCH GLADBACH Telephone / Fax: +49 221 4005 130 / +49 221 4005 7144 Web site: http://www.kbv.de E-mail: EBCN@kbv.de Contact person: Dr. LAWRENCE VON KARSA E-mail: LKarsa@KBV.de	Partner Countries B,D,DK,E,EL,F,FIN,I,L,NL,P,S,UK
Start of Project 1/08/2000	Duration of Project (months) 15
Project Objectives and Action Plans The European Breast Cancer Screening Network, initiated by the Europe Against Cancer Programme supports the long-term aim and commitment of the Cancer Programme, i.e., to reduce the number of cancer deaths. Well organised breast cancer screening programmes can reduce breast cancer mortality by 30 %. During the past 10 years, the network has focused on all aspects in the chain of activities related to breast cancer screening, for example, identifying of target population, implementation of high quality mammography screening and interpretation, setting QA standards in epidemiology, quality control in physics and pathology, publishing QA Guidelines suitable for European use, controlling quality by visiting projects on-site, and encouraging studies on evaluation of the activities, both in terms of quality and in terms of the effect on mortality. The main purpose of the breast cancer screening network is to improve the quality and effectiveness of breast cancer screening service in Europe. The basis for these activities is described in the European Guidelines for Quality Assurance in Mammography Screening (2nd edition) of which >2,500 copies have been distributed. A projected endpoint for the members of this network is the establishment of a reference centre having the expertise in building up national breast cancer screening programme. Special attention is given to training of all personnel involved in the screening process. Network members representing countries with nation-wide screening are helping and guiding countries with new projects, provide expert input to the Guidelines, and are developing study-models for evaluation. With the prospect that the Cancer Programme will finish after year 2000, this final application of the Network will focus on summarising the achievements made during the years of its existence, finishing already started projects, and by surveying the present breast cancer screening service in all member states. Major activities of the Network are: - Activities directly related to the quality of the screening process: i.e. improvement of compliance, double reading of mammograms, documentation of activities, including optimising cancer registries, monitoring physical quality control, adequacy of the assessment process, surgical management of screen detected lesions, and monitoring of surgical and other end point data. - Supportive activities: i.e. training, site visits, external physico-technical control and national development of guidelines and protocols. - Feasibility studies related to breast cancer screening: i.e. Cost effectiveness evaluation, harmonisation of cyto-pathology classification, psychological aspects of screening. - Models for evaluation the impact on mortality by screening. The Breast Cancer Screening Network has 21 members, and one co-ordinating office. Madeira, Lisbon, and Coimbra represent one Portuguese project. All together there are 23 projects applying for funding. These projects have been structured into 5 groups, co-ordinated by group leaders. Each project in the Network may carry out more than one of the activities mentioned below.
Outcomes of the project Executive summary of the final report(38 KB) Final report, March 2002(249 KB)

Title of Project - EURO-GLOBALINK - TELECOMMUNICATION SUPPORT FOR EUROPEAN SMOKING PREVENTION ORGANISATIONS
Organization Name: INTERNATIONAL UNION AGAINST CANCER Address: 3, rue du Conseil Général CH-1205 - GENEVA Telephone / Fax: ( + 41-22 ) 809 18 11 / ( + 1-22 ) 809 18 10 Web site: E-mail: globalink@uicc.org Contact person: Mr. THOMAS TURNBULL	Partner Countries
Start of Project 1/01/2000	Duration of Project (months) 9
Project Objectives and Action Plans To develop and operate GLOBALink, The International Tobacco-Control Network. A communication service with more than 850 Members covering all Europe : - linking intergovernmental, national and non-governmental organisations via a secure information system and electronic-conferences, increasing efficiency through improved communication, multimedia and coordination - supporting the communication infrastructure of most the European Smoking Prevention Organizations - providing instant access to an interactive computer information service with an expanding multimedia data base of reference and resource materials, regular news bulletins and 'action alerts'.