It is estimated that in fact 40% of all of us are likely to face this disease at some stage of our lives, and nearly all of us already know someone who is suffering from it. It is also estimated that by 2035, the incidence of cancer in the EU could double, making the disease the leading cause of death in middle age ahead of cardiovascular disease. Without the introduction of further measures (actions) that would reverse current trends, it could become the leading cause of death in the European Union.
However dire as the predictions are, the good news is that we now know that 40% of cancer cases can be prevented. Although it is caused by a combination of multiple factors, including genetic predisposition, environmental influences, lifestyle and infectious agents, avoiding known risk factors as well as adopting healthy lifestyles can significantly reduce the risk of disease. (Figure 1).
Prevention is the easiest and most effective way to reduce the incidence of cancer in the EU, while science, on the other hand, continues to improve the diagnosis and treatment of cancer itself, offering hope to those who are already ill. However, currently only an average of 3% of the health budget is spent on prevention across the EU.
In addition to its impact on health, cancer as a disease throughout Europe represents a significant financial burden for national health and social systems, for state budgets as well as for productivity and economic growth, because it includes a healthy workforce. Health care costs for cancer in the EU-27 are growing at an unprecedented rate, driven by demographic change and the spread of health innovations. Overall, the economic impact on cancer of Europe is estimated to exceed 100 billion euros per year.
In addition, substantial inequalities exist both within and between EU countries in areas such as the incidence of cancer or access to diagnosis and treatment , as well as in the availability of professional staff, scientific research and innovation.
The EU has been actively working for decades to reduce the incidence of cancer, and today we can see the results of that work. The first 'Cancer Plan', dating back to the late 1980s, resulted in the adoption of important laws in the EU, regarding the use of tobacco products and the preservation of health in the work environment. Since then, EU member states have taken a number of actions and committed themselves, in line with the United Nations Sustainable Development Goals, to reducing premature mortality from chronic diseases, including cancer, by one third by 2030. They also pledged to meet the WHO target for non-communicable diseases, which is to reduce cancer mortality by 25%.
What European Beating Cancer Plan aim to achieve and how ?
This plan aims to maximize the outcomes of research and innovation, to advance general knowledge and raise awareness about this disease. One quarter of the world's cancer cases are in Europe, which accounts for less than 10% of the world's population. It is evident that cancer is a huge public health problem in Europe that significantly burdens national health systems. It is necessary for everyone to work together focused on the same goal, hence patients, industry and researchers.
Advances in cancer treatment also require better sharing of knowledge and data. Digitization in healthcare can enable hospital systems to be improved, as well as patients to have better access to care and treatment. Better implementation of cancer registries will be crucial through anonymous data collection in line with the EU Data Protection Directive.
The EU cancer plan strategy consists of three key elements:
a) Addressing continuity in the approach from prevention and early detection to therapy and health care.
b) Research in which the individual is in focus
c) Encouraging and promoting partnerships in the EU and globally (Figure 2.)
With the support of Member States, decision-makers and the European Parliament, including members of the MEPs Against Cancer group who worked with the Commission to improve cancer prevention and health care in Europe, the idea is for the European plan to complement existing Member States' national cancer plans.
The development of the EU cancer plan itself will be closely linked to the Cancer Mission, Horizon Europe's new Framework Program 7 for Research and Innovation initiative, which maximizes the impact of EU support for research and innovation and demonstrates its importance to society. (Figure 3.)
The European Cancer Plan will include activities to support, coordinate or complement Member States' efforts at all key stages of the disease, from: prevention, early diagnosis and screening, treatment and care, quality of life of patients, survivors and carers. The plan should include a combination of legislative and non-legislative measures.
Why is it important to include every stakeholder into the decision making process ?
It is extremely important to involve all decision makers immediately in the development of the Cancer Plan in order to ensure in time that the plan is good and functional, i.e. immediately applicable. It is much easier to use already existing programs and plans that have already been implemented and implement their knowledge and thus avoid mistakes. The European Cancer Organization emphasizes the importance of the authors of the Cancer Plan who seek direct interaction with relevant organizations on issues specific to their areas of activity that will contribute to the implementation of the Plan within the set deadlines.
The European Cancer Organization (ECO), as the umbrella Federation of 28 organizations at European and international level, which works closely with 17 patient organizations at European level, can be a good partner for the Commission to reach a wide range of participants at the same time.
What does the European Beating Cancer Plan cover?
The European Cancer Plan has a holistic approach to cancer, because cancer, like no other chronic disease, affects almost all aspects of an individual's life, so it is necessary to address them all along the way.
The Plan consists of 4 key pillars
Prevention: An important fact is that more than 40% of all cancers can be prevented by coordinated action on individual, social and commercial health determinants. The European Code Against Cancer, an initiative of the European Commission, is an important starting point / document for informing the population about actions that can be taken by individuals and / or families to reduce the risk of cancer. However, possible environmental factors will also need to be further scientifically assessed and widely discussed and debated, in order to reduce exposure to toxic chemicals in the workplace and the environment.
Diagnosis: Early detection involves action steps for screening and timely diagnosis. It is important that the screening program is accredited to be effective, with particular emphasis on screening programs for breast, cervical and colorectal cancer. It is unacceptable that we have a huge difference and inequality between European countries in diagnosing late-stage cancer. Comprehensive oncology health care is needed, the existence of comprehensive cancer treatment centers (proved to be important for improving the survival of patients). Each EU member state must have at least one center of excellence for the treatment of patients.
Therapy: It is important to address the inequality in the availability of quality and adequate health care and the availability of medicines through this Plan but also through the strategy for cooperation with the pharmaceutical industry. It is necessary to encourage innovations that we know have significantly contributed to increasing patient survival rates in the last 30 years. It is also necessary that the regulatory framework is clearly defined for all countries, and in cases of medical need that there are rapid approval schemes. This is especially true for orphan medicinal products (OMPs).
Survival and quality of life: Includes psychosocial problems, rehabilitation of oncology patients, patients with recurrence (return) of the disease, but also the rights of oncology patients to employment and social insurance. A special section is dedicated to cancer in the pediatric population. There are many rare cancers in this population for which, either no, or adequate treatment is not available to most. Cancer patients must receive adequate psychological, nutritional, social, financial and aesthetic support, not only from them but also from their families. Support for returning to work, school, reproductive health and adequate health insurance is also important for quality of life.
Cancer is a complex set of diseases and every stage in the cancer control continuum requires different tools and services. Europe’s Beating Cancer Plan should complement and amplify the impact of national and regional cancer control plans.
