In the Azores, the Regional Program to Combat Cancer (PRS 2030) is aligned with the National Strategy and the European Plan to Fight Cancer. It establishes a set of performance indicators that include increasing participation in screenings organized by the Regional Health Service (SRS), to ensure timely access to treatment, including radiotherapy and nuclear medicine, and to measure patient-reported outcomes (PROMs and PREMs) across the region, according to the document released by the Regional Health Directorate (DRS) in June 2025 through a Normative Circular.

The program is based on four pillars: prevention, early detection, diagnosis and treatment, and survivors, and will be managed by the Azores Oncology Center (COA), with technical monitoring by the Regional Health Directorate.

The diagnosis underpinning the plan is clear: cancer accounts for about a quarter of deaths in the Azores (25% in 2022) and is also the leading cause of potential years of life lost (33.6% in 2017). The standardized mortality rate for malignant tumors in the region has remained above the national average, requiring an integrated response across all islands. On average, there are more than 1,100 new cases per year, with a higher incidence in men (56%).

In 2021, the most frequent tumors were breast (159 cases, 16%), trachea/bronchi/lung (132, 13%), colon and rectum (96, 9%), and prostate (76, 8%).

In terms of early detection, the government has committed to 100% geographical and population coverage of existing screening programs and specific participation targets: breast (ROCMA) above 75%, cervix (ROCCA) above 70%, colon and rectum (ROCCRA) above 50%, and oral cavity (PICCOA) above 65%. A pilot lung cancer screening program is also planned for populations at increased risk, given the regional incidence of this disease. At the same time, information systems will be modernized, with an emphasis on interoperability (including the mysaude Açores app) and the utilization of artificial intelligence to enhance adherence and diagnostic accuracy.

In the diagnosis and treatment pillar, the indicators focus on compliance with Maximum Guaranteed Response Times (TMRG) in suspected or confirmed cancer cases, equity of access between islands, with reinforcement of travel mechanisms and the Special Supplement for Cancer Patients (CEDO), guaranteed access to radiotherapy and nuclear medicine within the TMRG, and integration into Tumor Boards and national/European networks for more differentiated pathology.

The plan includes technological and human resource reinforcement, access to therapeutic innovation and clinical trials, and systematic evaluation of the effectiveness, cost, and equity of therapies, based on PROMs/PREMs.

In the survivor pillar, the Region is committed to increasing the response of Continuing and Palliative Care, including at home, creating psychosocial support networks, and adopting European follow-up tools, such as the “Cancer Survivor SmartCard” and the “European Cancer Patient Digital Centre,” to improve quality of life and continuity of care.

In the prevention pillar, the goals intersect with other PRS 2030 programs: reducing the prevalence of smokers (≥15 years) to less than 10%, cutting overall tobacco consumption by 35%, and increasing smoking cessation consultations by 25%; vaccination policies (HPV, hepatitis) are also reinforced, as are actions on alcohol, nutrition, exercise, and sun protection, including for exposed professional sectors.

To assess the real impact on health outcomes, the program sets targets for Potential Years of Life Lost (PYLL) per 100,000 inhabitants: lung cancer <200, cervical cancer <45, female breast cancer <150, and colorectal cancer/anus cancer <85. These indicators will be monitored annually by the Azores Oncology Center and the Regional Health Directorate, based on official data from INE and SREA. The performance of screenings will be scrutinized in quarterly reports under the contract with USIs and hospitals.

The governance of PRS 2030 is based on Government Council Resolution No. 67/2024, supplemented by Orders No. 1511/2024 and 1512/2024, which establish the management structure and local coordinators; the president of the COA was appointed program manager by Order No. 2484/2024 (December 12). The executive aims to increase Azorean applications to the Horizon Europe/Cancer Mission, EU4Health, and RIS3 programs by 50% and review the coordination between councils and committees to streamline implementation and reporting processes.

In practical terms, the plan promises more regular and digital invitations for screenings, shorter care pathways between primary healthcare and the hospital, response times monitored in near real-time, guaranteed access to differentiated therapies, and structured follow-up after the end of treatment, with results measured by the patients themselves. All this within a framework of inter-island equity and public transparency of indicators.

In Diário dos Açores, Paulo Viveiros, director

Translated into English as a community outreach program by the Portuguese Beyond Borders Institute (PBBI) and the Modern and Classical Languages and Literatures Department (MCLL), in collaboration with Bruma Publication and ADMA (Azores-Diaspora Media Alliance) at California State University, Fresno. PBBI thanks Luso Financial for sponsoring NOVIDADES.