Europe’s Beating Cancer Plan takes a comprehensive approach and is designed to noticeably reduce the number of cancer cases in Europe by enabling increased prevention and better detection, diagnosis and treatment.
Text: Dietmar Schobel
“Together we can make a difference with prevention and with research, with equal access to healthcare across Europe, standing at the side of those who need us.” – This was the description given by President of the European Commission Ursula von der Leyen to describe the vision behind Europe’s Beating Cancer Plan, which was presented by the Commission in early February 2021. The Plan is intended to counter the rise in cancer cases across Europe and bring noticeable improvements for citizens in the European Union (EU). “It will therefore affect all areas – from prevention to early detection, diagnosis and treatment, and also improve the quality of life for cancer patients, survivors, and their family members,” explains John F. Ryan, Deputy Director-General in the Directorate-General for Health and Food Safety of the European Commission. Furthermore, the strategy will fight cancer across all departments and it will reflect the fact that our health is dependent not only on medical care, but also on the many policies outside the health sector – such as employment, education and social policy, agriculture, environment and climate.
“Europe’s Beating Cancer Plan will affect all areas – from prevention to early detection, diagnosis and treatment.”
JOHN F. RYAN, DEPUTY-DIRECTOR GENERAL IN THE DIRECTORATE-GENERAL FOR HEALTH AND FOOD SAFETY
In 2020 2.7 million people in the European Union were diagnosed with cancer – a term that refers to a group of over 100 diseases that are characterised by uncontrolled growth and division of cells. 1.3 million people died from one of these diseases in 2020, and experts estimate that the number of deaths from cancer will increase by 24 percent by 2035 if we don’t act now. Cancer would then become the most frequent cause of death in the EU. Worse still, despite these sobering figures, are the personal stories of suffering, need and death. Every one of us has relatives, friends or acquaintances who are or have been personally affected. Many of us either have had or currently have cancer ourselves. Half of the population will receive a cancer diagnosis at least once. The risk is 50 percent for men and 45 percent for women.
Ambitious goals
This is set to change, and Europe’s Beating Cancer Plan specifies ambitious goals. One of these is ensuring that less than 5 percent of the population uses tobacco by 2040 – compared with around 25 percent today. Another is to vaccinate at least 90 percent of girls in the relevant age group against human papillomaviruses (HPV) by 2030 in order to prevent cervical cancer and other forms of cancer that are caused by HPV. The Plan also requires a significant increase in the number of boys who are vaccinated against HPV. A further objective is to offer breast, cervical and colorectal cancer screenings to 90 percent of EU citizens who qualify for them by as early as 2025.
These are just some examples of the numerous actions laid out in Europe’s Beating Cancer Plan, which was supported by the European Parliament’s Special Committee on Beating Cancer (BECA) in an 18-month project. Statements from national parliaments and also hundreds of experts, organisations and EU citizens were considered. In February 2021 the strategy against cancer was subsequently approved by the European Commission, with ten flagship initiatives and multiple supporting measures set for implementation by 2025 (see also box: “Ten flagship initiatives”). A roadmap provides the timetable for each initiative.
30-50 percent are avoidable
Many preventative measures are also described in the Plan. Experts estimate that no less than 30-50 percent of cancer cases are avoidable. According to figures from the World Health Organization (WHO), tobacco consumption alone is responsible for 27 percent of all cancer diagnoses. The possibility of higher taxation on tobacco, alcohol, sugar and lemonade, and also tax incentives for healthy foods, are therefore just as important for Europe’s Beating Cancer Plan as more stringent regulations on marketing potentially harmful products on TV, the radio, internet and in print media.
Measures that have already been implemented include the new EU directives on reducing workers’ exposure to carcinogens, mutagens, or reprotoxic substances, where the threshold values have been lowered and new substances taken into account. These were passed in March 2022 and, following adoption, the Member States now have two years to comply with the agreed changes. As early as in June 2021, the Knowledge Centre on Cancer was established, a new online platform managed by the EU Joint Research Centre. This Centre is aimed at supporting the exchange of knowledge and a coordinated approach in the fight against cancer within the European Union.
The 24 European Reference Networks have existed since 2017 and have a similar goal, to enable knowledge transfer among experts. The focal area for four of these networks includes rare forms of cancer, and further European Reference Networks for cancer will be established in line with Europe’s Beating Cancer Plan. The European Cancer Inequalities Registry has been online since February 2022 and will supply reliable data as a basis specifically for reducing inequalities between Member States and regions of the EU.
Huge differences
These inequalities are considerable. For instance, there is a 20 percent difference in the survival rate between individual countries following breast cancer treatment. The five-year survival rate for colon cancer ranges between 49 to 68 percent. “On the whole, the five-year survival rate for all forms of cancer is roughly estimated at about 60 percent in Western European, but at only about 50 percent in Eastern European Member States,” remarks Thomas Hofmarcher, researcher at the Swedish Institute for Health Economics. Participation in screening programmes also differs hugely. About 6-90 percent of the female target population attend breast cancer screening programmes, and about 25-80 percent are screened for cervical cancer, depending on the Member State.
The five-year survival rate for all forms of cancer is at about 60 percent in Western , but at only about 50 percent in Eastern European Member States.
THOMAS HOFMARCHER, RESEARCHER AT THE SWEDISH INSTITUTE FOR HEALTH ECONOMICS
In recent decades there has been massive progress in the diagnosis and treatment of cancers, and over the past ten years alone around 100 new prescription drugs have been launched on the market to treat various forms of the disease. But the average waiting period until cancer medication is made available to patients following approval by the European Medicines Agency ranges between 35 days in Germany and 981 days in Latvia, according to the Patients W.A.I.T. Indicator for 2015 to 2018, commissioned by the European Federation of Pharmaceutical Industries and Associations (EFPIA).
Eliminating the postcode lottery
“A patient’s postcode must not influence whether they will survive cancer or not,” emphasises German physician and biomedicine expert Bettina Ryll, Chair of Melanoma Patient Network Europe and Member of the EU Cancer Mission Board. The latter is a group of 15 experts who are providing targeted support for the implementation of cancer research within the EU research and innovation programme, Horizon Europe. She became the patients’ advocate after her husband was diagnosed with advanced melanoma in 2011. Less than a year later, he died from the disease. Overall, Bettina Ryll is positive about Europe’s Beating Cancer Plan: “It is a remarkable feat just to have succeeded in developing such an extensive joint strategy despite all the different initial situations and interests of the 27 Member States of the European Union.”
A patient’s postcode must not influence whether they will survive cancer or not.
BETTINA RYLL, CHAIR OF MELANOMA PATIENT NETWORK EUROPE
At the European Commission, the strategy in the fight against cancer is also a key pillar of the European Health Union. This is precisely why health economist Thomas Hofmarcher would like implementation to become quicker and more decisive: “So far only initial, small steps have been taken, and the financing for Europe’s Beating Cancer Plan is comparably small if you consider the economic costs of the disease.”
The costs to the EU economy total around 170 billion euros per year, of which around 100 billion are for treatment and care, and about 70 billion due to loss of productivity – such as loss of working hours as a result of cancer. In contrast, the budget for the implementation of Europe’s Beating Cancer Plan is only four billion euros over several years. It remains to be seen if this will be enough to bring measurable success. In any event, the Directorate-General for Health and Food Safety has been tasked with tracking and documenting progress using measurable indicators.
10 Flagship Initiatives
Europe’s Beating Cancer Plan includes multiple supporting actions and the following 10 “flagship initiatives” that are set for implementation between 2022 and 2030:
1 Knowledge Centre on Cancer 2022
2 European Cancer Imaging Initiative 2022
3 Vaccinate at least 90 percent of girls and a significant increase of boys against human papillomaviruses 2030
4 EU Cancer Screening Scheme 2025
5 EU Network linking recognised National Comprehensive Cancer Centres in all Member States 2025
6 Cancer Diagnostic and Treatment for All Initiative 2025
7 European Initiative to Understand Cancer (UNCAN.eu) 2025
8 Better Life for Cancer Patients Initiative 2023
9 Cancer Inequalities Registry 2022
10 Helping Children with Cancer Initiative 2023
Source: Factsheet: “EU Health Union: Europe’s Beating Cancer Plan”, European Commission, 3 February 2021